Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis.

Autor: Lincango Naranjo EP; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA.; Department of Teaching and Research, Hospital Vozandes Quito, Quito 170521, Ecuador.; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, 01067 Dresden, Germany., Garces-Delgado E; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador., Siepmann T; Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, 01067 Dresden, Germany.; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany., Mirow L; Department of General and Visceral Surgery, Medical Campus Chemnitz of the TU Dresden, 01307 Dresden, Germany., Solis-Pazmino P; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA., Alexander-Leon H; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad de las Américas, Quito 170503, Ecuador., Restrepo-Rodas G; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador., Mancero-Montalvo R; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador., Ponce CJ; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador., Cadena-Semanate R; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Medical School, Universidad Internacional del Ecuador, Quito 170411, Ecuador., Vargas-Cordova R; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Division of Metabolic and Weight Loss Surgery, Hospital General San Francisco IESS, Quito 170111, Ecuador., Herrera-Cevallos G; Equipo de Investigación de la Sociedad Ecuatoriana de Cirugía Bariátrica y Metabólica (SECBAMET), Quito 170508, Ecuador.; Division of Metabolic and Weight Loss Surgery, Hospital Metropolitano, Quito 170521, Ecuador., Vallejo S; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA., Liu-Sanchez C; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima 15102, Peru., Prokop LJ; Mayo Clinic Libraries, Mayo Clinic, Rochester, MN 55905, USA., Ziogas IA; Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA., Vailas MG; 1st Department of Surgery, Laikon General Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece., Guerron AD; Division of Metabolic and Weight Loss Surgery, Department of Surgery, Duke University, Durham, NC 27705, USA., Visser BC; Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Stanford University, Stanford, CA 94305, USA., Ponce OJ; Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN 55905, USA.; Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey GU16 7UJ, UK., Barbas AS; Department of Surgery, Duke University, Durham, NC 27705, USA., Moris D; Department of Surgery, Duke University, Durham, NC 27705, USA.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 May 05; Vol. 11 (9). Date of Electronic Publication: 2022 May 05.
DOI: 10.3390/jcm11092603
Abstrakt: The introduction of robotics in living donor liver transplantation has been revolutionary. We aimed to examine the safety of robotic living donor right hepatectomy (RLDRH) compared to open (ODRH) and laparoscopic (LADRH) approaches. A systematic review was carried out in Medline and six additional databases following PRISMA guidelines. Data on morbidity, postoperative liver function, and pain in donors and recipients were extracted from studies comparing RLDRH, ODRH, and LADRH published up to September 2020; PROSPERO (CRD42020214313). Dichotomous variables were pooled as risk ratios and continuous variables as weighted mean differences. Four studies with a total of 517 patients were included. In living donors, the postoperative total bilirubin level (MD: −0.7 95%CI −1.0, −0.4), length of hospital stay (MD: −0.8 95%CI −1.4, −0.3), Clavien−Dindo complications I−II (RR: 0.5 95%CI 0.2, 0.9), and pain score at day > 3 (MD: −0.6 95%CI −1.6, 0.4) were lower following RLDRH compared to ODRH. Furthermore, the pain score at day > 3 (MD: −0.4 95%CI −0.8, −0.09) was lower after RLDRH when compared to LADRH. In recipients, the postoperative AST level was lower (MD: −0.5 95%CI −0.9, −0.1) following RLDRH compared to ODRH. Moreover, the length of stay (MD: −6.4 95%CI −11.3, −1.5) was lower after RLDRH when compared to LADRH. In summary, we identified low- to unclear-quality evidence that RLDRH seems to be safe and feasible for adult living donor liver transplantation compared to the conventional approaches. No postoperative deaths were reported.
Databáze: MEDLINE
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