Robot-assisted laparoscopic liver resection for hepatocellular carcinoma: short-term outcome

Am J Surg. 2013 Jun;205(6):697-702. doi: 10.1016/j.amjsurg.2012.08.015. Epub 2013 Apr 3.

Abstract

Background: This study aimed at analyzing the perioperative and early survival outcomes of robotic liver resection of hepatocellular carcinoma (HCC).

Methods: The study population included a consecutive series of patients with HCC who underwent robotic liver resection at a single center.

Results: During the study period, 41 consecutive patients with HCC underwent 42 robotic liver resections. Five resections (11.9%) were carried out for recurrent HCC, and 23.8% (n = 10) were hemihepatectomy procedures. The mean operating time and blood loss was 229.4 minutes and 412.6 mL, respectively. The R0 resection rate was 93%. The hospital mortality and morbidity rates were 0% and 7.1%, respectively. The mean hospital stay was 6.2 days. The 2-year overall and disease-free survival rates were 94% and 74%, respectively. In the subgroup analysis of minor liver resection, when compared with the conventional laparoscopic approach, the robotic group had similar blood loss (mean, 373.4 mL vs 347.7 mL), morbidity rate (3% vs 9%), mortality rate (0% vs 0%), and R0 resection rate (90.9% vs 90.9%). However, the robotic group had a significantly longer operative time (202.7 mins vs 133.4 mins).

Conclusions: This study demonstrated the feasibility and safety of robotic surgery for HCC, with favorable short-term outcome. However, the long-term oncologic results remain uncertain.

MeSH terms

  • Blood Loss, Surgical / statistics & numerical data
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / surgery*
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Humans
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Liver Neoplasms / mortality
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Operative Time
  • Postoperative Complications
  • Prospective Studies
  • Robotics*