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Journal of Gastrointestinal Surgery

Published in:

01-09-2019 | Original Article

Learning Curve in Robot-Assisted Laparoscopic Liver Resection

Authors: Peng Zhu, Wei Liao, Ze-yang Ding, Lin Chen, Wan-guang Zhang, Bi-xiang Zhang, Xiao-ping Chen

Published in: Journal of Gastrointestinal Surgery | Issue 9/2019

Abstract

Background

The objective of this study was to evaluate the learning curve effect on the safety and feasibility of robot-assisted liver resection (RALR).

Methods

In 140 consecutive cases, all data about demographic, surgical procedure, postoperative course were collected prospectively and analyzed. Risk-adjusted cumulative sum model was used for determining the learning curve based on the need for conversion.

Results

Among all 140 patients, no patients suffered from any organ dysfunction postoperatively and the operative mortality was 0%. The CUSUM analysis showed that at the 30th consecutive patient, the open conversion rate reached to the average value, and it further improved thereafter. In the last 70 patients, only 3 patients (4.3%) required conversion and 7 patients (10%) needed blood transfusion. Only 1 patient (1.3%) out of 79 patients with HCC had a positive resection margin. Univariate analyses showed the following risk factors associated with significantly higher risks of conversion (P < 0.05): tumor number > 1, lesions in segments 1/4a/7/8, right posterior sectionectomy, and lesions which were beyond the indications of the Louisville statement. Multivariate logistic analysis revealed that both tumor number > 1 (OR: 2.10, P < 0.05) and right posterior sectionectomy (OR: 11.19, P < 0.01) were risk factors of conversion.

Conclusions

The robotic approach for hepatectomy is safe and feasible. A learning curve effect was demonstrated in this study after the 30th consecutive patient. The long-term oncological outcomes of robotic hepatectomy still need further investigation.

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Title: Learning Curve in Robot-Assisted Laparoscopic Liver Resection
Authors: Peng Zhu
Wei Liao
Ze-yang Ding
Lin Chen
Wan-guang Zhang
Bi-xiang Zhang
Xiao-ping Chen
Publication date: 01-09-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 9/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3689-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Learning Curve in Robot-Assisted Laparoscopic Liver Resection

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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