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A decade of experience with 530 minimally invasive robotic hepatectomies from a single tertiary hepatobiliary center: analysis of short-term outcomes and oncologic survival.
Christodoulou, Maria; Pattilachan, Tara Menon; Ross, Sharona B; Lingamaneni, Gowtham; Sucandy, Iswanto.
Afiliação
  • Christodoulou M; Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States.
  • Pattilachan TM; Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States.
  • Ross SB; Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States.
  • Lingamaneni G; Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States.
  • Sucandy I; Digestive Health Institute AdventHealth Tampa, Tampa, Florida, United States. Electronic address: Iswanto.sucandy.MD@adventhealth.com.
J Gastrointest Surg ; 28(8): 1273-1282, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38821208
ABSTRACT

BACKGROUND:

This research is the first study in the United States to document more than a decade of experience with 530 patients who underwent robotic hepatectomy at a single high-volume institution.

METHODS:

With institutional review board approval, a prospectively collected database of consecutive patients who underwent robotic hepatectomy from 2012 to January 2024 was reviewed. Data are presented as median (mean ± SD).

RESULTS:

Of the 530 robotic hepatectomies, 231 (44.0%) were minor resections, 133 (25.0%) were technically major resections, and 166 (31.0%) were major resections. The patients were aged 63.0 (61.0 ± 14.7) years with a body mass index of 28.0 (29.0 ± 7.9) kg/m2. Cirrhosis was present in 80 patients (19.0%), with an American Society of Anesthesiologists score of 3.0 (3.0 ± 0.5) and a Model for End-Stage Liver Disease score of 7.0 (8.0 ± 3.0). Of note, 280 patients (53.0%) had previous abdominal operations, and 44 patients (8%) had previous liver resections. The operative time was 233.0 (260.0 ± 130.7) minutes, and the estimated blood loss was 100.0 (165.0 ± 205.0) mL. Moreover, 353 patients (66%) had hepatectomies for neoplastic disease, and 500 patients (95%) had an R0 resection margin. The tumor size was 4.0 (5.0 ± 3.6) cm. The total 90-day postoperative complications were 45 (8%), of which 21 (4%) were classified as major complications (Clavien-Dindo score of >III). The length of stay was 3.0 (4.0 ± 3.7) days, and the 30-day readmission rate was 86 (16%). The overall survival rates at 1, 3, and 5 years were 82%, 65%, and 59% for colorectal liver metastases, 84%, 68%, and 60% for hepatocellular carcinoma, and 79%, 61%, and 50% for intrahepatic cholangiocarcinoma, respectively.

CONCLUSION:

After a decade of application and optimization at a high-volume institution, the robotic approach has been demonstrated to be a safe and effective approach to liver resection.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Robóticos / Hepatectomia / Neoplasias Hepáticas Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Procedimentos Cirúrgicos Robóticos / Hepatectomia / Neoplasias Hepáticas Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article