Is robotic liver resection feasible in patients with lesions in close proximity to major vessels? A propensity score matching analysis.

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2024-09-29 DOI:10.1016/j.hpb.2024.09.010

Edoardo M Muttillo, Leonardo L Chiarella, Francesca Ratti, Paolo Magistri, Andrea Belli, Giammauro Berardi, Giuseppe M Ettorre, Graziano Ceccarelli, Francesco Izzo, Marcello G Spampinato, Nicola De Angelis, Patrick Pessaux, Tullio Piardi, Fabrizio Di Benedetto, Luca Aldrighetti, Riccardo Memeo

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引用次数: 0

Abstract

Introduction: Robotic surgery is widely diffused in the surgical field and is becoming increasingly prevalent, however several aspects need more detailed assessment. One of them concerns the role of robotic liver surgery for lesions in contact with major vascular (CMV) pedicles. The aim of our study is to evaluate and compare intra and post operative outcomes in patients undergoing robotic liver resections between lesions in contact or free from major vessels.

Methods: A multicentric retrospective study was performed including 1030 patients who underwent robotic liver resection. Patients were divided into two groups according to vascular contact. Intra and post-operative outcomes were compared between the groups before and after Propensity Score Matching.

Results: After propensity score matching 889 patients were included in the study. Among these lesions, 595 were not in contact with major vessels (NCMV) and 294 were in contact with major vessels (CMV). Use of Pringle Manoeuvre was more associated with CMV resections (49.8 % vs 31.2 %, p = 0,0001). No differences in terms of operative time, conversion rate, morbidity and type of complications were observed after PSM.

Conclusion: The presents study shows how robotic surgery is a valid and safe technique also for resection of tumors close to vascular pedicles.

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病变靠近大血管的患者是否可行机器人肝脏切除术？倾向得分匹配分析

导言：机器人手术已广泛应用于外科领域，并日益普及，但有几个方面需要更详细的评估。其中一个方面涉及到机器人肝脏手术在治疗与大血管（CMV）血管蒂接触的病变方面的作用。我们的研究旨在评估和比较接受机器人肝脏切除术的患者在接触或不接触大血管的病变中的术中和术后效果：我们进行了一项多中心回顾性研究，包括 1030 名接受机器人肝脏切除术的患者。根据血管接触情况将患者分为两组。比较了倾向得分匹配前后两组患者的术中和术后结果：经过倾向评分匹配后，889 名患者被纳入研究。在这些病变中，595 例未与大血管接触（NCMV），294 例与大血管接触（CMV）。使用普林格尔手法（Pringle Manoeuvre）与CMV切除术更相关（49.8% vs 31.2%，p = 0,0001）。PSM术后在手术时间、转换率、发病率和并发症类型方面均无差异：本研究表明，机器人手术对于切除靠近血管蒂的肿瘤也是一种有效而安全的技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).