Implementing a robotic liver resection program does not always require prior laparoscopic experience
| Autor: | F. Melandro, S Meli, Jessica Bronzoni, Davide Ghinolfi, E Balzano, Laura Crocetti, Giuseppe Arenga, Lorenzo Bernardi, Giovanni Tincani, Paolo De Simone, Giandomenico Luigi Biancofiore |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Hepatocellular carcinoma Robot Outcomes Chronic liver disease Learning curve Liver resection Severity of Illness Index End Stage Liver Disease Liver disease Postoperative Complications Robotic Surgical Procedures Internal medicine medicine Hepatectomy Humans Retrospective Studies business.industry Incidence (epidemiology) Liver Neoplasms Retrospective cohort study Hepatology Length of Stay medicine.disease Surgery Concomitant Laparoscopy business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 36(5) |
| ISSN: | 1432-2218 |
| Popis: | Background Preliminary experience in laparoscopic liver surgery is usually suggested prior to implementation of a robotic liver resection program. Methods This was a retrospective cohort analysis of patients undergoing robotic (RLR) versus laparoscopic liver resection (LLR) for hepatocellular carcinoma at a center with concomitant initiation of robotic and laparoscopic programs Results A total of 92 consecutive patients operated on between May 2014 and February 2019 were included: 40 RLR versus 52 LLR. Median age (69 vs. 67; p = 0.74), male sex (62.5% vs. 59.6%; p = 0.96), incidence of chronic liver disease (97.5% vs.98.1%; p = 0.85), median model for end-stage liver disease (MELD) score (8 vs. 9; p = 0.92), and median largest nodule size (22 vs. 24 mm) were similar between RLR and LLR. In the LLR group, there was a numerically higher incidence of nodules located in segment 4 (20.0% vs. 16.6%; p = 0.79); a numerically higher use of Pringle’s maneuver (32.7% vs. 20%; p = 0.23), and a shorter duration of surgery (median of 165.5 vs. 217.5 min; p = 0.04). Incidence of complications (25% vs.32.7%; p = 0.49), blood transfusions (2.5% vs.9.6%; p = 0.21), and median length of stay (6 vs. 5; p = 0.54) were similar between RLR and LLR. The overall (OS) and recurrence-free (RFS) survival rates at 1 and 5 years were 100 and 79 and 95 and 26% for RLR versus 96.2 and 76.9 and 84.6 and 26.9% for LLR (log-rank p = 0.65 for OS and 0.72 for RFS). Conclusions Based on our results, concurrent implementation of a robotic and laparoscopic liver resection program appears feasible and safe, and is associated with similar oncologic long-term outcomes. |
| Databáze: | OpenAIRE |
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