Fei Xie1, Jin Ge1, Weiwei Sheng1, Dongdong Wang1, Wenjun Liao1, Enliang Li1, Linquan Wu2,3, Jun Lei4,5. 1. Department of General Surgery, Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang, 330006, China. 2. Department of General Surgery, Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang, 330006, China. Wulqnc@163.com. 3. Jiangxi Province Engineering Research Center of Hepatobiliary Disease, Nanchang, China. Wulqnc@163.com. 4. Department of General Surgery, Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang, 330006, China. manderly123@sina.com. 5. Jiangxi Province Engineering Research Center of Hepatobiliary Disease, Nanchang, China. manderly123@sina.com.
Abstract
BACKGROUND: In terms of perioperative outcomes, compared with traditional open surgery and laparoscopic surgery, studies of robotic liver resection have been limited and must be further clarified. METHODS: Clinical data from 465 patients who underwent liver resection were collected in this retrospective study, and the IWATE criteria were used to evaluate the difficulty level of each operation. We compared perioperative outcomes of open, laparoscopic, or robotic approaches for patients with uncomplicated and complex hepatectomy according to different IWATE scores. Among patients with uncomplicated hepatectomy, the median operation time was significantly longer in the robotic liver resection (RLR) group than in the open liver resection (OLR) and laparoscopic liver resection (LLR) groups; however, the RLR group had the shortest hospital stay. There were no significant differences in intraoperative blood loss, conversion rate, total complication rate, or serious complication rate among the three groups. RESULTS: Among patients with complex hepatectomy, the RLR group had the smallest intraoperative blood loss and shortest mean length of stay. The cases converted to open hepatectomy were lower in the RLR group than in the laparoscopic group, mainly based on the IWATE score of expert hepatectomy. The incidence of general and serious postoperative complications in the RLR group was significantly lower than that in the OLR and LLR groups. CONCLUSIONS: Robotic liver resection is a safe and feasible surgical method that is more advantageous than laparoscopic and open liver resection, especially in complex liver surgery.
BACKGROUND: In terms of perioperative outcomes, compared with traditional open surgery and laparoscopic surgery, studies of robotic liver resection have been limited and must be further clarified. METHODS: Clinical data from 465 patients who underwent liver resection were collected in this retrospective study, and the IWATE criteria were used to evaluate the difficulty level of each operation. We compared perioperative outcomes of open, laparoscopic, or robotic approaches for patients with uncomplicated and complex hepatectomy according to different IWATE scores. Among patients with uncomplicated hepatectomy, the median operation time was significantly longer in the robotic liver resection (RLR) group than in the open liver resection (OLR) and laparoscopic liver resection (LLR) groups; however, the RLR group had the shortest hospital stay. There were no significant differences in intraoperative blood loss, conversion rate, total complication rate, or serious complication rate among the three groups. RESULTS: Among patients with complex hepatectomy, the RLR group had the smallest intraoperative blood loss and shortest mean length of stay. The cases converted to open hepatectomy were lower in the RLR group than in the laparoscopic group, mainly based on the IWATE score of expert hepatectomy. The incidence of general and serious postoperative complications in the RLR group was significantly lower than that in the OLR and LLR groups. CONCLUSIONS: Robotic liver resection is a safe and feasible surgical method that is more advantageous than laparoscopic and open liver resection, especially in complex liver surgery.
Authors: Kevin P Labadie; David J Droullard; Alex W Lois; Sara K Daniel; Kathryn E McNevin; Jaqueline Valdez Gonzalez; Yongwoo D Seo; Kevin M Sullivan; Kyle S Bilodeau; Lindsay K Dickerson; Alan F Utria; John Calhoun; Venu G Pillarisetty; Jonathan G Sham; Raymond S Yeung; James O Park Journal: Surg Endosc Date: 2021-02-19 Impact factor: 4.584