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Role of laparoscopic and robotic liver resection compared to open surgery in elderly hepatocellular carcinoma patients: a systematic review and meta-analysis

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Hepatoma Research 2020年第6期6卷 77-91页

作者： Alberto Brolese Marta Rigoni Alessandro Vitale Giovanni de Pretis Ivo Avancini CeciliaPravadelli Michela Frisinghelli Umberto Rozzanigo Giacomo Luppi Francesco Dionisi Stefano Marcucci Giovanni Viel Paolo Beltempo Cristina Prezzi Marco Frisini Marco Brolese Giandomenico Nollo Francesco A.Ciarleglio Department of General surgery&HPB Unit(Chief:Alberto Brolese MD)Azienda Provinciale per i Servizi Sanitari(APSS)Santa Chiara HospitalTrento 38122Italy IRCS-Innovation and Clinical Health Research-Bruno Kessler Foundation(FBK) Trento 38123Italy Department of Surgical Oncological&Gastroenterological SciencesPadua University HospitalPadua 35128Italy Department of Hepatology&Gastroenterology APSSTrento 38122Italy Department of Oncology Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy Department of Radiology Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy Proton therapy Unit Azienda Provinciale per i Servizi Sanitari(APSS)Trento 38122Italy Department of Industrial Engineering BIOtech LabUniversity of TrentoTrento 38122Italy School of Medicine Padua UniversityPadua 35128Italy

Aim:This study aimed to compare mini-invasive liver resection(MILR)(laparoscopic/robotic approach)and open liver resection(OLR)for hepatocellular carcinoma(HCC)in elderly patients with regard to clinical and oncological outcomes through a comprehensive systematic ***:The MEDLINE and Cochrane Library electronic databases were systematically searched from 2009 to December 2019 to identify relevant English written studies comparing MILR and *** main endpoints were Child-Pugh score,serum total bilirubin level,comorbidity,presence/absence of cirrhosis,minor/major resection,challenge segment approach,operative time,estimated intraoperative blood loss,liver failure rate,morbidity according to the Clavien-Dindo classification,length of hospital stay(LOS),postoperative mortality,number of lesions,tumor size,readmission rate,recurrence rate and survival at 1,3 and 5 years after ***-analyses provided pooled relative risks and mean differences for these ***-off for"elderly age"was set at 65 years ***:Eight studies that evaluated 3051 patients who underwent liver resection for HCC,with 950 undergoing MILR and 2101 OLR,were included after the screening *** loss,morbidity,and LOS showed statistical significance in favor of *** particular,with respect to OLR,MILR decreased on average blood loss by 161.43 mL(95%CI:250.24-72.61),risk of morbidity by 42%(Pliver resection to HCC patients with borderline liver *** may be considered an important treatment o

关键词： Hepatocellular carcinoma HCC mini-invasive liver resection laparoscopic liver surgery robotic liver surgery open liver surgery meta-analysis

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robotic donor hepatectomy:a niche advancement or the way forward?A perspective from the world’s largest center

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Hepatoma Research 2022年第1期8卷 1-8页

作者： Mark Sturdevant Ahmed Zidan Dieter Broering Department of surgery Division of TransplantationUniversity of Washington Medical CenterSeattleWA 98195USA Department of liver and Small Bowel Transplantation&HPB surgery Organ Transplant CenterKing Faisal Specialist Hospital and Research CenterRiyadh 11211Saudi Arabia Al Faisal University Riyadh 11211Saudi Arabia

The application of minimally invasive liver surgery(MILS)in the field of living donor hepatectomy has been exceedingly slow,and its impact is limited to a handful of centers *** adoption has been primarily hampered by the technical limitations of laparoscopy,namely rigid instrumentation,suboptimal optics,and a seemingly steep learning *** deficiencies are magnified in the donor hepatectomy operation wherein the parenchyma and vasculature must be handled atraumatically to produce a pristine allograft fit for *** safety concerns and medicolegal ramifications are also cited as impediments to MILS in donor *** 2013,our institution embraced a purely laparoscopic approach to living donor left lateral sectionectomy,and it quickly became our default ***,with donor hemi-hepatectomy,we gravitated to the robotic surgical system as our preferred ***,we describe our experience with minimally invasive donor hepatectomy,which we now universally offer to all living *** extensive familiarity with robotic donor hepatectomy will provide the reader with an instructive perspective on the attributes and merits of the robotic *** appropriate collaboration and proctorship,we believe that the robotic platform will actualize a more rapid and widespread adoption than that experienced with the purely laparoscopic technique.

关键词： robotic liver surgery robotic living donor hepatectomy minimally invasive donor hepatectomy live donor liver transplant

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