Simultaneous Robot Assisted Colon and Liver Resection for Metastatic Colon Cancer

Abstract

Introduction: Simultaneous robot assisted colon and liver resections are being performed more frequently at present due to the expanded adoption of the robotic platform for surgical management of metastatic colon cancer. However, this approach has not been studied in detail with only case series available in the literature. The aim of this systematic review was to evaluate the current body of evidence on the feasibility of performing simultaneous robotic colon and liver resections.Methods: A systematic review was performed through PubMed to identify relevant articles describing simultaneous colon and liver resections for metastatic colon cancer.Results: A total of 28 patients underwent simultaneous resections robotically with an average operative time of 420.3 minutes and average blood loss of 275.6 ml. Postoperative stay was 8.6 days on average with all cases achieving negative surgical margins.Conclusions: Robotic simultaneous resection of colorectal cancer with liver metastases is technically feasible and seems oncologically equivalent to open or laparoscopic surgery. Further studies are urgently needed to assess benefits of robotic surgery in the patient population.

Efficacy and Safety of rCCK96-104PE38 Targeted Drug in the General Surgical Treatment of Colon Cancer

“…Currently, renaturation is still a difficult topic to overcome. In the renaturation rate, the renaturation cycle in which denaturation in a short time after renaturation still cannot meet the expectation [ 19 – 21 ]. In general, methods that reduce the rate of protein synthesis not only increase the proportion of soluble protein but also make the protein activity stable and suitable for high expression.…”

Robotic surgery for colorectal liver metastases resection: A systematic review

“…9,25,26,[28][29][30][31][32][33] Baseline characteristics of patients are superimposable to other experiences on liver surgery reported in literature. We compared our data to the cases series published by Kasai 20 Regarding obese patients a high BMI is often associated with metabolic, hepatic and cardiopulmonary comorbidities, however, we report in the selected studies a mean BMI often major than 25. As already depicted in literature by Viganò, obesity should not dissuade surgeons from using a robotic approach to liver resections.…”

“…[25][26][27][28][29][30][31][32][33][50][51][52][53]57 McGuirk review reports superimposable data (8.6 days vs. 7.98 days). 20 It is difficult to explain the reason why the robotic approach needed a longer hospital stay, but probably the low experience in robotic resections in several centres not dedicated to HPB caused a delayed recovery.…”

Multivisceral Resection in Robotic Liver Surgery

“…In this article, we have reviewed the reported cases of simultaneous robotic multivisceral resection in liver surgery, including combined colectomy or proctectomy, pancreatectomy, and other resections. With combined robotic colorectal and hepatic resection, a systematic review of 50 cases has been reported in the literature thus far, with a single death due to the underlying cancer at 26 months [ 24 ]. Over time, the number of published cases per year has shown an increasing trend ( Figure 1 ).…”

“…A review of eight studies collectively reported no conversions to open with combined robotic-assisted colorectal and liver resection, a 28.6% rate of total postoperative complications, and one (3.6%) postoperative mortality in a patient who died of CRC [ 24 ]. Most recently, the experience of 28 cases from the Minimally Invasive Robotic-Assisted combined Colorectal and Liver Excision Surgery (MIRACLES) study was reported.…”