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Titel: Robotic and laparoscopic liver resection : comparative experiences at a high-volume German academic center
Autor(en): Lorenz, Eric
Arend, JörgIn der Gemeinsamen Normdatei der DNB nachschlagen
Franz, Mareike
Rahimli, MirhasanIn der Gemeinsamen Normdatei der DNB nachschlagen
Perrakis, AristotelisIn der Gemeinsamen Normdatei der DNB nachschlagen
Negrini, Victor
Gumbs, Andrew A.
Croner, RolandIn der Gemeinsamen Normdatei der DNB nachschlagen
Erscheinungsdatum: 2021
Art: Artikel
Sprache: Englisch
URN: urn:nbn:de:gbv:ma9:1-1981185920-1032360
Schlagwörter: Minimally invasive
Liver surgery
Hepatectomy
Robotic
CRC
HCC
Zusammenfassung: Purpose Minimally invasive liver surgery (MILS) is a feasible and safe procedure for benign and malignant tumors. There has been an ongoing debate on whether conventional laparoscopic liver resection (LLR) or robotic liver resection (RLR) is superior and if one approach should be favored over the other. We started using LLR in 2010, and introduced RLR in 2013. In the present paper, we report on our experiences with these two techniques as early adopters in Germany. Methods The data of patients who underwent MILS between 2010 and 2020 were collected prospectively in the Magdeburg Registry for Minimally Invasive Liver Surgery (MD-MILS). A retrospective analysis was performed regarding patient demographics, tumor characteristics, and perioperative parameters. Results We identified 155 patients fulfilling the inclusion criteria. Of these, 111 (71.6%) underwent LLR and 44 (29.4%) received RLR. After excluding cystic lesions, 113 cases were used for the analysis of perioperative parameters. Resected specimens were significantly bigger in the RLR vs. the LLR group (405 g vs. 169 g, p = 0.002); in addition, the tumor diameter was significantly larger in the RLR vs. the LLR group (5.6 cm vs. 3.7 cm, p = 0.001). Hence, the amount of major liver resections (three or more segments) was significantly higher in the RLR vs. the LLR group (39.0% vs. 16.7%, p = 0.005). The mean operative time was significantly longer in the RLR vs. the LLR group (331 min vs. 181 min, p = 0.0001). The postoperative hospital stay was significantly longer in the RLR vs. the LLR group (13.4 vs. LLR 8.7 days, p = 0.03). The R0 resection rate for solid tumors was higher in the RLR vs. the LLR group but without statistical significance (93.8% vs. 87.9%, p = 0.48). The postoperative morbidity ≥ Clavien-Dindo grade 3 was 5.6% in the LLR vs. 17.1% in the RLR group (p = 0.1). No patient died in the RLR but two patients (2.8%) died in the LLR group, 30 and 90 days after surgery (p = 0.53). Conclusion Minimally invasive liver surgery is safe and feasible. Robotic and laparoscopic liver surgery shows similar and adequate perioperative oncological results for selected patients. RLR might be advantageous for more advanced and technically challenging procedures.
URI: https://opendata.uni-halle.de//handle/1981185920/103236
http://dx.doi.org/10.25673/101281
Open-Access: Open-Access-Publikation
Nutzungslizenz: (CC BY 4.0) Creative Commons Namensnennung 4.0 International(CC BY 4.0) Creative Commons Namensnennung 4.0 International
Sponsor/Geldgeber: Projekt DEAL 2021
Journal Titel: Langenbeck's archives of surgery
Verlag: Springer
Verlagsort: Berlin
Band: 406
Heft: 3
Originalveröffentlichung: 10.1007/s00423-021-02152-6
Seitenanfang: 753
Seitenende: 761
Enthalten in den Sammlungen:Medizinische Fakultät (OA)

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