Publications by authors named "Robles Campos Ricardo"
Minimally invasive liver surgery has become widely accepted as a safe and effective approach, especially with experienced surgeons. Robotic hepatectomy may offer significant benefits in challenging procedures like caudate lobe resection. The caudate lobe's intricate anatomy and deep-seated location make its resection particularly challenging, with limited reports on minimally invasive techniques.
View Article and Find Full Text PDFBackground: The adoption of robotic techniques in liver surgery introduces significant challenges for their safe integration within hepatobiliary surgery units. This study is designed to investigate the complexities associated with establishing a robotic surgery program.
Methods: Data on robotic hepatobiliary surgeries were prospectively collected from October 2021 to October 2023.
Article Synopsis
- The Barcelona Clinic Liver Cancer (BCLC) staging system is crucial for treating hepatocellular carcinoma (HCC); recent updates allow for BCLC stage B patients to consider liver transplantation, while hepatectomy is now discouraged.
- A systematic review analyzed 31 studies involving 3163 patients to compare survival rates, postoperative complications, and patient selection for liver resection versus transplantation in BCLC stage B patients.
- Results showed that while resection had a 50-month survival and a 15-month recurrence-free period, data on transplantation was limited, with only one study reporting on it, indicating the need for more research in this area.
Article Synopsis
- A study was conducted to compare robotic minor liver resections (RMLR) with laparoscopic minor liver resections (LMLR) in patients undergoing surgery on the anterolateral liver segments.
- The analysis included over 10,000 patients and employed propensity score matching to balance the groups for accuracy in comparisons.
- Results indicated RMLR had benefits like less blood loss, lower major morbidity, and shorter hospital stays than LMLR, although the difference in 30-day readmission rates suggested RMLR may have some drawbacks.
Objective: We analyzed the use of a self-expandable absorbable biliary stent (SEABS) to reduce biliary complications in liver transplant (LT).
Background: Complications related to biliary anastomosis are a still a challenge in LT with a high impact on the patient outcomes and hospital costs.
Methods: This non-randomized prospective study was conducted between July 2019 and September 2023 in adult LT patients with duct-to-duct biliary anastomoses.
Article Synopsis
- The study aimed to create global benchmark outcome indicators for laparoscopic right posterior sectionectomies (L-RPS/H67) to improve surgical standards.
- It analyzed data from 854 patients across 57 centers globally, establishing key performance benchmarks for low-risk cases based on specific outcome indicators.
- The findings set standard benchmarks for metrics like operation time and complication rates, serving as a reference for surgical auditing and improvement.
Article Synopsis
- The study aimed to establish a common language regarding extreme liver surgery to facilitate better comparison of surgical outcomes across different centers.
- A Delphi methodology was used, gathering opinions from 38 expert surgeons, who largely agreed on key definitions related to total vascular occlusion and surgical approaches, achieving consensus on various topics.
- Ultimately, 75% agreed on a definition for extreme liver surgery, highlighting the importance of a unified approach in managing patients with complex liver diseases.
Article Synopsis
- The study investigates the risk factors and outcomes related to open conversion during minimally invasive liver resections (MILR), especially in minor hepatectomies, highlighting its association with inferior results.
- Analysis was conducted on data from over 10,500 patients who underwent laparoscopic or robotic liver resections from 2004 to 2020, identifying key independent predictors for open conversion.
- Results show that patients who required open conversion experienced longer recovery times, increased blood loss, higher complications, and elevated 90-day mortality rates compared to those who had successful minimally invasive surgeries.
Background: In recent years, there has been growing interest in laparoscopic liver resection (LLR) and the audit of the results of surgical procedures. The aim of this study was to define reference values for LLR in segments 7 and 8.
Study Design: Data on LLR in segments 7 and 8 between January 2000 and December 2020 were collected from 19 expert centers.
Impact of neoadjuvant chemotherapy on short-term outcomes after simple and complex minimally invasive minor hepatectomy for colorectal liver metastases: A propensity-score matched and coarsened exact matched study.
Eur J Surg Oncol
June 2024
Article Synopsis
- Minimally invasive liver surgery has become more common over the last 30 years, especially for treating colorectal liver metastases, but the effects of neoadjuvant chemotherapy on surgical outcomes are not well understood.
- A study analyzed a large database of nearly 5,000 patients who underwent minimally invasive liver surgeries to compare outcomes between those who received neoadjuvant chemotherapy and those who did not.
- The results showed that neoadjuvant chemotherapy did not significantly affect the short-term surgical outcomes in patients undergoing these liver procedures.
Correction: Explainable artificial intelligence prediction-based model in laparoscopic liver surgery for segments 7 and 8: an international multicenter study.
Surg Endosc
May 2024
Article Synopsis
- A study was conducted to compare the perioperative outcomes of robotic liver surgery (RLS) and laparoscopic liver surgery (LLS) across various healthcare settings from 2009 to 2021.
- The results showed that RLS had better outcomes in terms of "textbook outcomes," lower blood loss, fewer complications, and shorter operative times compared to LLS after matching patient groups for bias.
- Despite the higher costs generally associated with robotic surgery, this study suggests that RLS may offer specific clinical advantages over LLS in minimally invasive liver procedures.
Article Synopsis
- * Data from 808 patients were analyzed, revealing that 46.9% achieved TO, with significantly lower overall complications (11.9% vs. 86%) compared to those who did not achieve TO, leading to increased major complications and mortality rates.
- * Factors enhancing the likelihood of achieving TO include treatment at specialized centers, initial surgery transfer, and conservative or surgical management, highlighting the importance of effective perioperative care in managing BDI.
Multimodal prehabilitation program in patients with resectable perihilar cholangiocarcinoma: keypoints for an implementation protocol and literature review.
Langenbecks Arch Surg
February 2024
Background: Postoperative complications after perihilar cholangiocarcinoma surgical procedure are still very high. The implementation of a multimodal prehabilitation program could improve these outcomes. Based on our experience and that of the literature in hepatobiliary and pancreatic surgery, we propose a protocol to promote its implementation.
View Article and Find Full Text PDFBackground: Artificial intelligence (AI) is becoming more useful as a decision-making and outcomes predictor tool. We have developed AI models to predict surgical complexity and the postoperative course in laparoscopic liver surgery for segments 7 and 8.
Methods: We included patients with lesions located in segments 7 and 8 operated by minimally invasive liver surgery from an international multi-institutional database.
Article Synopsis
- This study assessed how liver cirrhosis (LC) influences the challenges of minimally invasive liver resection (MILR), specifically for minor surgeries involving primary liver tumors in anterolateral segments.
- Conducted from 2004 to 2021 across 60 centers, the research involved 3,675 patients, with varying degrees of cirrhosis classified as Child A and Child B.
- Results indicated that patients with Child A cirrhosis faced higher risks of complications, such as increased blood loss and rates of open conversion, while those with Child B cirrhosis had longer hospital stays and more significant morbidity; overall, the severity of LC complicates the surgical process, highlighting the need for better difficulty
Article Synopsis
- Minimally invasive liver resections (MILR) can reduce blood loss and recovery time compared to traditional methods, but the impact of cirrhosis on these procedures is not fully understood.
- A study reviewed data from 2534 patients who underwent minimally invasive major liver surgeries worldwide, focusing on outcomes related to different levels of cirrhosis.
- Results showed that advanced cirrhosis leads to higher blood transfusion rates, more postoperative complications, and longer hospital stays, suggesting that cirrhosis severity should be considered in future assessments of surgical difficulty in MILR.*
Article Synopsis
- The study investigates how cirrhosis and portal hypertension (PHT) affect the complexity and outcomes of minimally invasive liver surgery in specific liver segments.
- It examines a large patient group, revealing that those with cirrhosis experienced more complications and required more blood transfusions during surgery.
- The findings suggest that the presence of cirrhosis and PHT should be considered when evaluating the difficulties and risks associated with minimally invasive liver resections.
This forum summarizes the proceedings of the joint European Surgical Association (ESA)/American Surgical Association (ASA) symposium on Quality and Outcome Assessment for Surgery that took place in Bordeaux, France, as part of the celebrations of the 30th anniversary of the ESA. Three presentations focused on a) the main messages from the Outcome4Medicine Consensus Conference, which took place in Zurich, Switzerland, in June 2022, b) the patient perspective, and c) benchmarking were hold by ESA members and discussed by ASA members in a symposium attended by members of both associations.
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- Tumor size (TS) impacts intraoperative outcomes in laparoscopic major hepatectomy (L-MH), with this study aiming to clarify its effects and find optimal TS cutoffs for assessing surgical difficulty.
- The analysis, which included 1396 patients from a larger pool of 3008 undergoing L-MH, identified two critical TS cutoffs at 50 mm and 100 mm that segmented patients into three distinct groups.
- Results showed that larger TS correlated with increased open conversion rates, longer operation times, higher blood loss, and more intraoperative blood transfusions, while postoperative complications remained similar across the groups.
Background And Aims: Alterations in liver histology influence the liver's capacity to regenerate, but the relevance of each of the different changes in rapid liver growth induction is unknown. This study aimed to analyze the influence of the degree of histological alterations during the first and second stages on the ability of the liver to regenerate.
Methods: This cohort study included data obtained from the International ALPPS Registry between November 2011 and October 2020.