Abstract
BackgroundTo evaluate the clinical efficacy of robotic, laparoscopic, and open hemihepatectomy for giant liver haemangiomas.MethodsFrom April 2011 to April 2017, consecutive patients who underwent hemihepatectomy for giant liver haemangiomas were included in this study. According to the type of operation, these patients were divided into the robotic hemihepatectomy (RH) group, the laparoscopic hemihepatectomy (LH) group, and the open hemihepatectomy (OH) group. The perioperative and short-term postoperative outcomes were compared among the three groups. The study was reported following the STROCSS criteria.ResultsThere were no significant differences in age, sex, tumour location, body surface area (BSA), future liver remnant volume (FLR), standard liver volume (SLV), liver haemangioma volume, FLR/SLV, resected normal liver volume/resected volume, hepatic disease, rates of blood transfusion, liver function after 24 h of surgery, operative morbidity and mortality among the three groups. Compared with patients in the RH group (n = 19) and the LH group (n = 13), patients in the OH group (n = 25) had a significantly longer postoperative hospital stay (P < 0.05), time to oral intake (P < 0.05), and time to get-out-of-bed (P < 0.05); a higher VAS score after 24 h of surgery (P < 0.05); and a shorter operative time (P < 0.05). There were no significant differences in these postoperative outcomes (P>0.05) between the RH group and the LH group. When the setup time in the RH group was excluded, the operative time in the RH group was significantly shorter than that in the LH group (P<0.05). There was no significant difference in the operative time between the RH group and the OH group (P>0.05). The amount of intraoperative blood loss in the RH group was the lowest among the three groups (P<0.05), and the amount of intraoperative blood loss in the LH group was less than that in the OH group (P<0.05).ConclusionRobotic and laparoscopic hemihepatectomies were associated with less intraoperative blood loss,better postoperative recovery and lower pain score. Compared with laparoscopic hemihepatectomy, robotic hemihepatectomy was associated with significantly less intraoperative blood loss and a shorter operative time.
Highlights
To evaluate the clinical efficacy of robotic, laparoscopic, and open hemihepatectomy for giant liver haemangiomas
There were no significant differences in age, sex, tumour location, body surface area (BSA), future liver remnant volume (FLR), standard liver volume (SLV), liver haemangioma volume, FLR/SLV, resected normal liver volume/resected volume, or hepatic disease among the three groups (Table 1)
The operative time of the open hemihepatectomy (OH) group was significantly shorter than that of the robotic hemihepatectomy (RH) group and the laparoscopic hemihepatectomy (LH) group (190.2 ± 51.8 vs 256.3 ± 57.7 and 268.4 ± 93.6 min, P0.05, Table 4)
Summary
To evaluate the clinical efficacy of robotic, laparoscopic, and open hemihepatectomy for giant liver haemangiomas. Asymptomatic patients with liver haemangiomas less than 5 cm in diameter require observation and no intervention [3]. Surgical treatment for liver haemangioma is required in lesions larger than 5 cm in diameter, when there are symptoms or complications, or when the diagnosis is uncertain [4]. The main treatments for liver haemangioma include transarterial embolization (TAE), enucleation, liver resection, and transplantation. Open liver resection requires a large abdominal incision and long recovery time. No study has been reported that has compared robotic, laparoscopic, and open liver resection for giant liver haemangiomas. The present study was undertaken to evaluate the clinical efficacy of robotic, laparoscopic and open hemihepatectomy for giant liver haemangioma
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