Perioperative outcomes after robotic repeat hepatectomy: A systematic review

IF 2.1 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2026-02-01 Epub Date: 2025-12-13 DOI:10.1016/j.suronc.2025.102342

Gianluca Cassese , Fabrizio Panaro , Fabio Giannone , Mariantonietta Alagia , Marco Palucci , Cristina Ciulli , Alessandro Fogliati , Mattia Garancini , Mauro Alessandro Scotti , Fabio Benedetti , Fabrizio Romano

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引用次数: 0

Abstract

Background

Robotic liver resection has widely spread in hepatopancreatobiliary surgery, with growing evidence even in challenging scenarios. However, the results of robotic hepatectomy in patients who have had previous liver operations (repeat Robotic Liver Resections, r-RLR) have not been deeply investigated so far.

Methods

A systematic review of the MEDLINE and SCOPUS databases was performed, including studies published until April 2025.

Results

A total of 4 studies including 118 patients met the inclusion criteria. Nineteen patients (16.1 %) had received 2 or more previous liver resections, with 92.4 % (n = 109) of the r-RLR that were performed for malignant lesions. Colorectal liver metastases represented the most common malignant indication (40.7 %), followed by recurrent hepatocellular carcinoma (36.4 %). Tumor size varied between 10 and 33 mm in the largest diameter. The weighted mean operative time was 200.8 min (SD: 112.3), and the weighted mean estimated blood loss was 134.3 mL (SD: 121.9). The weighted mean hospital length of stay was 4.7 days (SD: 4.7). One case of open conversion was reported (0.8 %). Six patients experienced major complications (5 %), with 1 (0.8 %) postoperative death.

Conclusion

Few retrospective studies investigating the outcomes of r-RLR are currently available in the literature. From published data, it may be a safe and feasible alternative to open and laparoscopic redo hepatectomy in selected patients in referral HPB centers. Further studies with larger sample sizes are needed to confirm such preliminary findings.

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机器人重复肝切除术后围手术期预后：一项系统综述。

背景：机器人肝切除在肝胆胰手术中广泛应用，即使在具有挑战性的情况下也有越来越多的证据。然而，机器人肝切除术对既往肝手术患者的效果（重复机器人肝切除术，r-RLR）迄今尚未深入研究。方法：对MEDLINE和SCOPUS数据库进行系统回顾，包括截至2025年4月发表的研究。结果：共有4项研究118例患者符合纳入标准。19例（16.1%）患者曾接受过2次或2次以上的肝脏切除术，其中92.4% （n = 109）的r-RLR是针对恶性病变进行的。结直肠肝转移是最常见的恶性指征（40.7%），其次是复发性肝细胞癌（36.4%）。肿瘤最大直径在10 ~ 33mm之间。加权平均手术时间200.8 min (SD: 112.3)，加权平均估计失血量134.3 mL （SD: 121.9）。加权平均住院时间为4.7天（SD: 4.7）。报告1例（0.8%）。6例患者出现严重并发症（5%），1例（0.8%）术后死亡。结论：目前文献中很少有回顾性研究调查r-RLR的结果。从已发表的数据来看，对于转介HPB中心的选定患者，它可能是一种安全可行的替代开放式和腹腔镜重做肝切除术的方法。需要更大样本量的进一步研究来证实这些初步发现。

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

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.