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Short-term outcomes of robotic liver resection: An initial singleinstitution experience

World Journal of Hepatology 2022年第1期14卷 224-233页

作者： Manuel Durán Javier Briceño Ana Padial Ferdinando Massimiliano Anelli Juan Manuel Sánchez-Hidalgo María Dolores Ayllón Rafael Calleja-Lozano Carmen García-Gaitan Unit of Hepatobiliary surgery and Liver Transplantation General and Digestive Surgery DepartmentReina Sofia University HospitalCordoba 14004Spain GC18 Translational research in surgery of Solid Organ Transplantation Maimonides Biomedical Research InstituteCórdoba 14004Spain ge09 research in peritoneal and retroperitoneal oncological surgery Maimonides Biomedical Research InstituteCórdoba 14004Spain Department of Anesthesiology and Resuscitation Reina Sofia University HospitalCordoba 14004Spain

BACKGROUND Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced *** robotic approach has gradually been introduced in liver surgery and has increased notably in recent ***,few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic *** To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary *** A total of forty consecutive patients underwent robotic liver resection(da Vinci Xi,***,United States)between June 2019 and January *** were prospectively followed and retrospectively *** characteristics and perioperative and short-term outcomes were *** are expressed as mean and standard *** study was approved by the Institutional Review *** The mean age of patients was 59.55 years,of which 18(45%)were *** mean body mass index was 29.41 kg/m^(2).Nine patients(22.5%)were *** were divided by type of resection as follows:Ten segmentectomies,three wedge resections,ten left lateral sectionectomies,six bisegmentectomies(two VVI bisegmentectomies and four IVb-V bisegmentectomies),two right anterior sectionectomies,five left hepatectomies and two right *** lesions occurred in twenty-nine(72.5%)of the *** mean operative time was 258.11 min and two patients were transfused intraoperatively(5%).Inflow occlusion was used in thirty cases(75%)and the mean total clamping time was 32.62 *** was a single conversion due to uncontrollable *** postoperative complications(Clavien–Dindo>Ⅲb)occurred in three patients(7.5%)and mortality in one(2.5%).No patient required readmission to the *** mean hospital stay was 5.6 *** Althou

关键词： Robotics Hepatectomy Minimally invasive surgery Liver surgery Da vinci

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Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review

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Chinese Journal of Traumatology 2019年第1期22卷 1-11页

作者： Yang Li Pei-Yuan Li Shi-Jing Sun Yuan-Zhang Yao Zhan-Fei Li Tao Liu Fan Yang Lian-Yang Zhang Xiang-Jun Bai Jing-Shan Huo Wu-Bing He Jun Ouyang Lei Peng Ping Hu Yan-An Zhu Ping Jin Qi-Feng Shao Yan-Feng Wang Rui-Wu Dai Pei-Yang Hu Hai-Ming Chen ge-Fei Wang Yong-Gao Wang Hong-Xu Jin Chang-Ju Zhu Qi-Yong Zhang Biao Shao Xi-Guang Sang Chang-Lin Yin Trauma Center of PLA State Key Laboratory of Trauma Bums and Combined Injury Institute of Surgery Research Doping Hospital Third Military Medical University Chongqing China Ninth People's Hospital of Zhengzhou Zhengzhou China Zhongnan Hospital of Wuhan University Wuhan China Chengdu Military general Hospital ChengduChina Tiantai County People's Hospital Tiantai Zhejiang China The First Affiliated Hospital of Nanchang University Nanchang China Department of surgery Jinling Hospital Medical School of Nanjing University Nanjing China Department of surgery The First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou China Shenyang Military general Hospital Shenyang China The First Affiliated Hospital of Zhengzhou University Zhengzhou China The Affiliated Hospital of Guizhou Medical University Guiyang China Trauma Center/Department of Emergency and Trauma surgery Tongji Hospital of Tongji Medical College Huazhong University of Science & Technology Wuhan China The First People's Hospital of Kunming Kunming China Qilu Hospital of Shandong University Jinan China The First Affiliated Hospital of Third Military Medical University Chongqing China Foshan Hospital of Traditional Chinese Medicine Foshan Guangzhou Province China Fujian Provincial Hospital Fuzhou China Emergency surgery of the First Affiliated Hospital Shihezi University School of Medicine Shihezi Xinjiang Autonomous Region China The First Affiliated Hospital of Hainan Medical University Haikou China Chongqing Emergency Medical Center Chongqing China Taizhou Hospital of Zhejiang Province Taizhou Zhejiang Province China Yuyao People's Hospital of Zhejiang Province Yuyao Zhejiang Province China

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal *** questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

关键词： Guideline Vacuum sealing drainage Abdominal surgery

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