Int J Med Robot - Robot assistance in liver surgery: a real advantage over a fully laparoscopic approach? Results of a comparative bi-institutional analysis.

Tópicos

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Resumo

CKGROUND: Laparoscopic liver resection (LAPR) is safe and feasible with a better postoperative course as compared to open resections. Robot-assisted liver surgery (ROBR) is a potential alternative to LAPR. In this study we compare outcomes between ROBR and LAPR.METHODS: Forty patients underwent ROBR and 223 LAPR for various indications. The surgical outcomes of two institutions, each with a specific advanced experience in laparoscopic and robotic surgery, were reviewed.RESULTS: The major hepatectomy rate was significantly higher in LAPR (16.6% vs 0%, p=0.011) while a parenchyma-preserving approach was favoured in ROBR (55% vs 34.1%, p=0.019). More nodules were resected in the ROBR group (1.97?1.4 vs 1.57?1.1, p=0.04). Overall conversion rate was 8/40 (20%) in the ROBR and 17/223 (7.6%) in the LAPR group (p=0.034). Mean blood loss was 330?303ml and 174?133ml for the ROBR and LAPR groups, respectively (p=0.001) CONCLUSIONS: Despite higher conversion rates and blood loss, robot-assisted surgery may allow the resection of more liver lesions, especially those located in the postero-superior segments, facilitating parenchyma-saving surgery with a comparable complication rate with respect to LAPR.

Resumo Limpo

ckground laparoscop liver resect lapr safe feasibl better postop cours compar open resect robotassist liver surgeri robr potenti altern lapr studi compar outcom robr laprmethod forti patient underw robr lapr various indic surgic outcom two institut specif advanc experi laparoscop robot surgeri reviewedresult major hepatectomi rate signific higher lapr vs p parenchymapreserv approach favour robr vs p nodul resect robr group vs p overal convers rate robr lapr group p mean blood loss ml ml robr lapr group respect p conclus despit higher convers rate blood loss robotassist surgeri may allow resect liver lesion especi locat posterosuperior segment facilit parenchymasav surgeri compar complic rate respect lapr

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