The Impact of Smoking History on Outcomes and Morbidity After Robotic Hepatectomy.

INTRODUCTION: The detrimental effects that smoking has on patient health and postoperative morbidity are well documented. However, literature on the impact that smoking history has on robotic surgery, specifically robotic hepatectomy, is scarce. This study was undertaken to determine whether smoking history impacts the postoperative course of patients undergoing robotic hepatectomy. METHODS: We prospectively followed 353 patients that underwent robotic hepatectomy. 125 patients had an apposite history of smoking (ie, smokers) and 228 patients were classified as non-smokers. Data were presented as median (mean ± SD). Patients were then propensity-score matched based on patient and tumor characteristics. RESULTS: Prior to the matching, the MELD score and cirrhosis status in patients who smoke were found to be significantly higher when compared to those who do not (mean MELD score 9 vs 8 and cirrhosis in 25% vs 13% of patients, respectively). Both smokers and non-smokers have similar BMIs, number of previous abdominal operations, ASA physical status classifications, and Child-Pugh scores. Six percent smokers vs one percent non-smokers experienced pulmonary complications (pneumonia, pneumothorax, and COPD exacerbation) (P = .02). No differences were found for postoperative complications of Clavien-Dindo score ≥ III, 30-day mortality, or 30-day readmissions. After the matching, no differences were found between the smokers and the non-smokers. CONCLUSION: After a propensity-score match analysis, smoking did not appear to negatively affect the intra- and postoperative outcomes after robotic liver resections. We believe that the robotic approach as the most modern minimally invasive technique in liver resection may have the potential to mitigate the known adverse effects of smoking.

A Case of Clear Cell Hidradenoma Found During Abdominal Cyst Excision.

Clear cell hidradenoma (CCH), a rare yet benign finding, is a tumor that originates from sweat glands. It mainly presents as a slow-growing cystic nodule on the scalp or trunk. We report a case of a 60-year-old man who presented with an abdominal subcutaneous mass. This mass was excised and pathology confirmed the presence of CCH, with cytology negative for malignant cells. Although benign, CCHs cannot be confirmed as such until excision and pathologic analysis, which is the standard treatment of choice.