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Robotic Liver Resection: A Case-Matched Comparison.

Publication ,  Journal Article
Kingham, TP; Leung, U; Kuk, D; Gönen, M; D'Angelica, MI; Allen, PJ; DeMatteo, RP; Laudone, VP; Jarnagin, WR; Fong, Y
Published in: World J Surg
June 2016

BACKGROUND: In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic hepatectomy, however, is still in its infancy. Our goals were to examine the adoption of robotic hepatectomy and to compare outcomes between open and robotic liver resections. METHODS: The robotic hepatectomy experience of 64 patients was compared to a modern case-matched series of 64 open hepatectomy patients at the same center. Matching was according to benign/malignant diagnosis and number of segments resected. Patient data were obtained retrospectively. The main outcomes and measures were operative time, estimated blood loss, conversion rate (robotic to open), Pringle maneuver use, single non-anatomic wedge resection rate, resection margin size, complication rates (infectious, hepatic, pulmonary, cardiac), hospital stay length, ICU stay length, readmission rate, and 90-day mortality rate. RESULTS: Sixty-four robotic hepatectomies were performed in 2010-2014. Forty-one percent were segmental and 34 % were wedge resections. There was a 6 % conversion rate, a 3 % 90-day mortality rate, and an 11 % morbidity rate. Compared to 64 matched patients who underwent open hepatectomy (2004-2012), there was a shorter median OR time (p = 0.02), lower median estimated blood loss (p < 0.001), and shorter median hospital stay (p < 0.001). Eleven of the robotic cases were isolated resections of tumors in segments 2, 7, and 8. CONCLUSIONS: Robotic hepatectomy is safe and effective. Increasing experience in more centers will allow definition of which hepatectomies can be performed robotically, and will enable optimization of outcomes and prospective examination of the economic cost of each approach.

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Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

June 2016

Volume

40

Issue

6

Start / End Page

1422 / 1428

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Liver Diseases
 

Citation

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ICMJE
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Kingham, T. P., Leung, U., Kuk, D., Gönen, M., D’Angelica, M. I., Allen, P. J., … Fong, Y. (2016). Robotic Liver Resection: A Case-Matched Comparison. World J Surg, 40(6), 1422–1428. https://doi.org/10.1007/s00268-016-3446-9
Kingham, T Peter, Universe Leung, Deborah Kuk, Mithat Gönen, Michael I. D’Angelica, Peter J. Allen, Ronald P. DeMatteo, Vincent P. Laudone, William R. Jarnagin, and Yuman Fong. “Robotic Liver Resection: A Case-Matched Comparison.World J Surg 40, no. 6 (June 2016): 1422–28. https://doi.org/10.1007/s00268-016-3446-9.
Kingham TP, Leung U, Kuk D, Gönen M, D’Angelica MI, Allen PJ, et al. Robotic Liver Resection: A Case-Matched Comparison. World J Surg. 2016 Jun;40(6):1422–8.
Kingham, T. Peter, et al. “Robotic Liver Resection: A Case-Matched Comparison.World J Surg, vol. 40, no. 6, June 2016, pp. 1422–28. Pubmed, doi:10.1007/s00268-016-3446-9.
Kingham TP, Leung U, Kuk D, Gönen M, D’Angelica MI, Allen PJ, DeMatteo RP, Laudone VP, Jarnagin WR, Fong Y. Robotic Liver Resection: A Case-Matched Comparison. World J Surg. 2016 Jun;40(6):1422–1428.
Journal cover image

Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

June 2016

Volume

40

Issue

6

Start / End Page

1422 / 1428

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surgery
  • Robotic Surgical Procedures
  • Retrospective Studies
  • Postoperative Complications
  • Operative Time
  • Middle Aged
  • Male
  • Liver Neoplasms
  • Liver Diseases