https://scholars.lib.ntu.edu.tw/handle/123456789/557685
標題: | Robotic Versus Open Right Lobe Donor Hepatectomy for Adult Living Donor Liver Transplantation: A Propensity Score–Matched Analysis | 作者: | Broering D.C. Elsheikh Y. Alnemary Y. Zidan A. Elsarawy A. Saleh Y. Alabbad S. Sturdevant M. YAO-MING WU Troisi R.I. |
公開日期: | 2020 | 出版社: | John Wiley and Sons Ltd | 卷: | 26 | 期: | 11 | 起(迄)頁: | 1455-1464 | 來源出版物: | Liver Transplantation | 摘要: | Robotic right lobe donor hepatectomy (RRLDH) is rarely performed, and data concerning its safety and efficacy are lacking. Here we compare our series of RRLDHs with a similar cohort undergoing open right lobe donor hepatectomy (ORLDH) with a propensity score–matched (PSM) analysis. Among 263 consecutive adult patients undergoing right lobe living donor hepatectomy from January 2015 until July 2019, 35 RRLDHs were matched to 70 ORLDHs. A 1:2 PSM analysis was performed to make the groups comparable for donor sex, age, and body mass index (BMI) and for recipient sex, age, BMI, Model for End-Stage Liver Disease score, and indication for transplant. Operative time was longer in RRLDHs compared with ORLDHs (504?±?73.5 versus 331?±?65.1?minutes; P?0.001) but significantly decreased with the number of patients (P?0.001). No conversions occurred. First warm ischemia time was longer and blood loss significantly less in RRLDHs (P?=?0.001 and 0.003, respectively). Overall donor complications were similar: 2 (6%) in RRLDHs versus 12 (17%) in ORLDHs (P?=?0.13). Biliary leak occurred in 1 (3%) patient receiving a robotic procedure and 2 (3%) patients receiving the conventional approach. Donors undergoing robotic surgery required less patient-controlled analgesia and had a shorter hospital stay compared with the open surgery group (P?0.001 and P?=?0.001, respectively). No significant differences in graft anatomical data and recipient outcomes were recorded. RRLDH is feasible, safe, and reproducible, with significantly decreased blood loss and a shorter hospital stay compared with the open procedure. The first 35 patients receiving the robotic procedure showed a substantial reduction in operative time, reflecting a rapid shortening of the learning curve. Copyright ? 2020 by the American Association for the Study of Liver Diseases. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85092097310&doi=10.1002%2flt.25820&partnerID=40&md5=df212c657030aea46f0b99d44b3f257f https://scholars.lib.ntu.edu.tw/handle/123456789/557685 |
ISSN: | 1527-6465 | DOI: | 10.1002/lt.25820 | SDG/關鍵字: | alanine aminotransferase; aspartate aminotransferase; bilirubin; acute graft rejection; acute hemorrhagic pancreatitis; adult; alanine aminotransferase level; arterial circulation; Article; ascites; aspartate aminotransferase level; bile leakage; bilirubin blood level; bleeding; body mass; female; fungemia; graft recipient; heart arrest; hepatic artery thrombosis; hospital readmission; human; intermethod comparison; intestine perforation; ischemia; laparotomy; length of stay; liver donor; liver resection; liver transplantation; living donor; lung embolism; major clinical study; male; Model For End Stage Liver Disease Score; mycosis; open surgery; operation duration; operative blood loss; patient controlled analgesia; pneumonia; portal vein obstruction; portal vein thrombosis; postoperative hemorrhage; postoperative pain; priority journal; propensity score; retransplantation; right liver lobe; robot assisted surgery; sepsis; sudden cardiac death; surgical mortality; surgical technique; vein reconstruction; visual analog scale; wound infection; adverse event; end stage liver disease; laparoscopy; liver resection; living donor; postoperative complication; retrospective study; severity of illness index; Adult; End Stage Liver Disease; Hepatectomy; Humans; Laparoscopy; Length of Stay; Liver Transplantation; Living Donors; Postoperative Complications; Propensity Score; Retrospective Studies; Robotic Surgical Procedures; Severity of Illness Index |
顯示於: | 醫學系 |
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