Long-Term Oncologic Outcomes Following Robotic Liver Resections for Primary Hepatobiliary Malignancies: A Multicenter Study

Khan, Sidrah; Beard, Rachel E.; Kingham, Peter; Fong, Yuman; Boerner, Thomas; Martinie, John B.; Vrochides, D.; Buell, Joseph F.; Berber, Eren; Kahramangil, Bora; Troisi, Roberto; Vanlander, Aude; Molinari, Michele; Tsung, Allan

doi:10.1245/s10434-018-6629-9

Cited by 66 publications

(46 citation statements)

References 44 publications

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“…48 Although the use of robotic technology has not been specifically evaluated for iCCA, encouraging results have been reported in a cohort of patients with different types of hepatic tumours treated by hepatectomy. 49 A recent consensus states that robotic LR is safe and has similar effectiveness to open hepatectomy in patients with hepatic malignances, although the level of evidence supporting this assertion is very low. 50…”

Section: Role Of Lymphadenectomymentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

231

182

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The incidence of intrahepatic cholangiocarcinoma (iCCA) is increasing worldwide. Although several advances have been made in the past decades to better understand this complex malignancy and to develop new treatment strategies, the prognosis of iCCA remains dismal. Liver resection (LR) is the mainstay of treatment but only a minority of patients are amenable to surgery. In most cases, patients with iCCA will require a major hepatectomy for complete resection of the tumour. This may be contraindicated or increase the surgical burden in patients with chronic liver disease and small remnant liver volume. Lymphadenectomy with a minimal harvest of 6 lymph nodes is considered adequate, as microscopic nodal metastases have been shown in more than 40% of patients. Current 5-year overall survival following LR is in the range of 25%-40%. For locally advanced disease not amenable to upfront LR, neoadjuvant locoregional therapies may be used with the aim of converting these patients to resectability or even to transplantation in well-selected cases. Recent studies have shown that liver transplantation (LT) might be a treatment option for patients with unresectable very-early iCCA (i.e. < − 2 cm), with survival outcomes comparable to those of hepatocellular carcinoma. In patients with unresectable, advanced tumours, confined to the liver who achieve sustained response to neoadjuvant treatment, LT may be considered an option within prospective protocols. The role of adjuvant therapies in iCCA is still under debate. Herein, we review the recent advances in the surgical treatment of iCCA and examine its correlation with locoregional therapies, adjuvant and neo-adjuvant strategies.

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Section: Role Of Lymphadenectomymentioning

confidence: 99%

Liver resection and transplantation for intrahepatic cholangiocarcinoma

Mazzaferro

Gorgen

Roayaie

et al. 2020

Journal of Hepatology

231

182

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“…Several studies using the da Vinci have been published recently that conclude robotic hepatectomy is a safe, feasible and effective alternative to laparoscopic liver resections. 13,[20][21][22] A study comparing robotic liver surgery with open and laparoscopic procedures demonstrated robotic hepatectomy to be non-inferior in their long term oncologic outcomes. 21 Some authors have also demonstrated that lesions in the right posterior liver segments are safe and feasible for robotic resection.…”

Section: Discussionmentioning

confidence: 99%

“…13,[20][21][22] A study comparing robotic liver surgery with open and laparoscopic procedures demonstrated robotic hepatectomy to be non-inferior in their long term oncologic outcomes. 21 Some authors have also demonstrated that lesions in the right posterior liver segments are safe and feasible for robotic resection. 23,24 A recent meta-analysis showed no difference in the transfusion rate, complication rate, conversion rate, the R1 resection rate and hospital stay between robot assisted and laparoscopic liver resection.…”

Section: Discussionmentioning

confidence: 99%

The role of robotics in liver surgery

Rai

Lin

2019

Int Surg J

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Laparoscopic surgery has become a staple in many tertiary care centres worldwide. However, due to the inherent limitations of laparoscopic surgery, adoption of minimal access approaches in surgery of the liver has been slow and patchy. Every hepatobiliary surgeon knows the limitations of laparoscopic surgery of the liver. Advanced robotic surgical systems have been introduced to fill gaps in the technical feasibility of minimal access liver resections We try to explore the use of advanced robotic systems in hepatobiliary surgery and how the novel system could help circumvent the inherent limitations of laparoscopic liver surgery. The manuscript reviews the current data concerning laparoscopic, as well as, open versus robotic approaches in liver surgery. Authors show that although robotic surgery is in its infancy, the promising role cannot be ignored. With the increasing trend towards parenchymal saving liver resection, robotics will only positively aid in the wider adoption and growth of minimally invasive techniques. Although robotics is still evolving, the need in liver surgery is evident. Further long-term research is required, however, to confirm the huge potential of robotics in liver surgery.

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“…Our study combined data from six different institutions across the United States and Europe of patients diagnosed with hepatocellular carcinoma, cholangiocarcinoma, or gallbladder cancer between 2006 and 2016 who then underwent robotic liver resections (5). We showed that overall survival and disease free survival of patients undergoing robotic liver surgery is comparable to the published data on laparoscopic liver surgery.…”

Section: Presentmentioning

confidence: 99%