Robotic Liver Surgery for Alveolar Echinococcosis: A Single-Centre Experience
Abstract
:1. Introduction
2. Results
2.1. Patients’ Baseline Characteristics
2.2. Surgical Details
2.3. Postoperative Course
3. Discussion
4. Materials and Methods
4.1. Patient Selection and Preoperative Management
4.2. Surgical Procedure
4.3. Clinical Definitions
4.4. Statistical Analysis
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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N = 16 | |
---|---|
Median age in years (range) | 55.5 (23–73) |
Median BMI in kg/m2 (range) | 25.8 (20.2–36.8) |
Gender | |
Female | 12 (75%) |
Male | 4 (25%) |
ASA * score | |
I | 1 (6.2%) |
II | 8 (50%) |
III | 7 (43.8%) |
WHO classification (PNM †) | |
P1N0M0 | 4 (25%) |
P2N0M0 | 5 (31.3%) |
P2N1M0 | 2 (12.5%) |
P3N0M0 | 4 (25%) |
P4N0M0 | 1 (6.2%) |
Distribution of affected liver lobes | |
Left | 5 (31.2%) |
Right | 5 (31.2%) |
Both | 6 (37.5%) |
Distribution of affected liver segments | |
II | 1(6.2%) |
II, III | 2 (12.5%) |
II, III, V | 1 (6.2%) |
II, III, V, VIII | 1 (6.2%) |
II, V | 1 (6.2%) |
II, III, IVa, IVb | 1 (6.2%) |
II, III, VIII | 1 (6.2%) |
III, IVb | 1 (6.2%) |
IVb, V, VIII | 1 (6.2%) |
V, VI, VII, VIII | 1 (6.2%) |
VI | 1 (6.2%) |
VI, VII | 2 (12.5%) |
II, III, VI und IV | 1 (6.2%) |
VI, VIII | 1 (6.2%) |
Number of Lesions | |
1 | 10 (62.5%) |
2 | 4 (25.0%) |
3 | 1 (6.2%) |
5 | 1 (6.2%) |
Median size of the lesions in cm (range) | 5.3 (2.0–12.0) |
Median time period of preoperative albendazole therapy in years (range) | 1.78 (0.1–9.0) |
N = 16 | |
---|---|
Extent of resection | |
Major (>3 segments) | 4 (25%) |
Minor (≤3 segments) | 12 (75%) |
Type of resection | |
Anatomic | 14 (87.5%) |
Non-anatomic | 2 (12.5%) |
Multivisceral resection * | 2 (12.5%) |
Previous hepatic surgery | 1 (6.2%) |
Surgical procedure | |
Right hemihepatectomy | 2 (12.5%) |
Extended right hemihepatectomy (ALPPS) | 1 (6.2%) |
Left hemihepatectomy | 1 (6.2%) |
Left lateral sectionectomy | 3 (18.8%) |
Anatomic segmentectomy † | 7 (43.8%) |
Atypical resection ‡ | 2 (12.5%) |
R-status | |
R0 | 12 (75%) |
R1 (<1 mm) | 4 (25%) |
Median duration of surgery in minutes (range) § | 251 (160–395) |
Median estimated blood loss in millilitre (range) ∥ | 300 (100–1500) |
Perioperative blood transfusions | 2 (12.5%) |
N = 16 | |
---|---|
90-day mortality | 0 (0%) |
90-day morbidity | |
Clavien–Dindo I–II | 3 (18.8%) |
Clavien–Dindo III–V | 1 (6.2%) |
Median comprehensive complication index (range) | 0 (0–33.5) |
Surgical site infection (SSI) | |
Superficial incisional SSI | 0 (0%) |
Deep incisional SSI | 0 (0%) |
Organ/space SSI | 1 (6.2%) |
Postoperative bile leakage | 0 (0%) |
Posthepatectomy haemorrhage | 0 (0%) |
Posthepatectomy liver failure | |
Grade A | 0 (0%) |
Grade B | 1 (6.2%) |
Grade C | 0 (0%) |
Pleural effusion | 1 (6.2%) |
Postoperative pancreatic fistula | |
Biochemical leakage (Grade A) * | 1 (6.2%) |
Grade B | 0 (0%) |
Grade C | 0 (0%) |
Reintervention † | 1 (6.2%) |
Reoperation | 0 (0%) |
Rehospitalization ‡ | 1 (6.2%) |
Median length of postoperative hospital stay in days (range) | 7 (4–30) |
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Steinkraus, K.C.; Jötten, L.; Traub, B.; Zaimi, M.; Denzinger, M.; Michalski, C.W.; Kornmann, M.; Hüttner, F.J. Robotic Liver Surgery for Alveolar Echinococcosis: A Single-Centre Experience. Pathogens 2022, 11, 1276. https://doi.org/10.3390/pathogens11111276
Steinkraus KC, Jötten L, Traub B, Zaimi M, Denzinger M, Michalski CW, Kornmann M, Hüttner FJ. Robotic Liver Surgery for Alveolar Echinococcosis: A Single-Centre Experience. Pathogens. 2022; 11(11):1276. https://doi.org/10.3390/pathogens11111276
Chicago/Turabian StyleSteinkraus, Kira C., Laila Jötten, Benno Traub, Marin Zaimi, Maximilian Denzinger, Christoph W. Michalski, Marko Kornmann, and Felix J. Hüttner. 2022. "Robotic Liver Surgery for Alveolar Echinococcosis: A Single-Centre Experience" Pathogens 11, no. 11: 1276. https://doi.org/10.3390/pathogens11111276