Safety And Short-term Outcomes Between Robot-assisted And Laparoscopic Hepatectomy

Background:With the development of minimally invasive concept,minimally invasive technology has gradually penetrated into all surgical fields.Minimally invasive surgery has become the key direction of medical development in the 21 st century.Robot-assisted surgery is the most advanced surgical technology,which has attracted much attention because of its accuracy,flexibility and stability.In the field of hepatobiliary surgery,the operation is difficult because of the complex anatomical structure and rich blood flow of liver.Therefore,robot-assisted surgery shows unique advantages.This research compared the safety and short-term outcomes of robot-assisted hepatectomy(RH)and laparoscopic hepatectomy(LH).Methods:The cases of robot-assisted hepatectomy and traditional laparoscopic hepatectomy carried out in our hospital from May 2020 to May 2021 were analyzed retrospectively,including 21 cases in the RH group and 34 cases in the LH group.The clinical data including operation time(OT),intraoperative bleeding(IBL),conversion rate,incidence of postoperative complications,R0 resection rate and postoperative length of stay(LOS)were collected and compared between two groups.Results:There was no death or reoperation in both groups.The operating time of RH group was 258±141 minutes and LH group was 215±94minutes(P = 0.386).The hepatic portal occlusion rate was 47.6% in RH group and 61.8% in LH group(P=0.304).The intraoperative blood loss in RH group was 371±383 ml and that in LH group was 572±516 ml(P =0.047).The intraoperative blood transfusion rate was 19.0% in RH group and 20.6% in LH group respectively(P = 0.890).One patient in RH group was converted to laparotomy(P=0.806).One patient in the LH group had a positive margin(P=1.000).The postoperative length of stay was 7.1±5.4 days in RH group and 7.5±3.0 days in LH group respectively(P=0.735).There were 3 cases of complications in RH group and 2 cases in LH group(P=0.568).Conclusion:There was no significant difference between laparoscopic hepatectomy and robot-assisted hepatectomy in intraoperative results such as operation time,intraoperative blood transfusion and R0 resection rate and in short-term outcomes such as complication rate and length of stay.The safety and effectiveness of them are similar.Robot-assisted surgery has advantages in reducing intraoperative blood loss.