Feasibility and safety of robotic liver resection for huge (≥10 cm) hepatocellular carcinoma in a single centre: A propensity score-matched single-surgeon study

IF 2.3 3区医学 Q2 SURGERY International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2024-03-22 DOI:10.1002/rcs.2628

Shurui Wu, Liu Boyuan, Tao Zeng, Ben Ma, Zhaoyi Lin, Minggen Hu

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Abstract

Background

The applicability of robot-assisted resection for huge hepatocellular carcinoma (HCC) of ≥10 cm remains contentious with limited available data.

Methods

This retrospective analysis involved 337 patients who underwent robotic liver resection for HCC by a single surgeon. Propensity score matching (PSM) was employed to compare perioperative indicators between patients with regular and huge HCC.

Results

The regular HCC group exhibited a shorter median operative duration than the huge HCC group. The IWATE criteria revealed higher scores in the huge HCC group than in the regular HCC group. No significant differences were observed between the two groups in Pringle time, drainage tube removal, duration of hospital stays, blood loss volume, blood product transfusion, margin status, conversion rate to open surgery, bile leakage, in-hospital mortality, and reoperation rate.

Conclusion

Robotic liver resection is feasible for huge HCC, with effective perioperative risk management potentially improving outcomes for subsequent minimally invasive surgeries.

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单中心巨大（≥10 厘米）肝细胞癌机器人肝切除术的可行性和安全性：倾向评分匹配单一外科医生研究。

背景：机器人辅助切除术是否适用于≥10厘米的巨大肝细胞癌（HCC）仍存在争议，且可用数据有限：这项回顾性分析涉及337名接受机器人肝切除术治疗HCC的患者，均由一名外科医生主刀。采用倾向评分匹配法（PSM）比较普通和巨大HCC患者的围手术期指标：结果：普通HCC组的中位手术时间短于巨大HCC组。IWATE标准显示巨大HCC组的得分高于普通HCC组。两组在普林格尔时间、拔除引流管、住院时间、失血量、输血量、边缘状态、转为开放手术率、胆汁渗漏、院内死亡率和再次手术率方面无明显差异：结论：机器人肝脏切除术对巨大的 HCC 是可行的，有效的围手术期风险管理有可能改善后续微创手术的预后。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.