Background: As the first comprehensive investigation into hospital readmissions following robotic hepatectomy for neoplastic disease, this study aims to fill a critical knowledge gap by evaluating risk factors associated with readmission and their impact on survival and the financial burden.
Methods: The study analyzed a database of robotic hepatectomy patients, comparing readmitted and non-readmitted individuals post-operatively using 1:1 propensity score matching. Statistical methods included Chi-square, Mann-Whitney U, T-test, binomial logistic regression, and Kaplan-Meier analysis.
Results: Among 244 patients, 44 were readmitted within 90 days. Risk factors included hypertension (p = 0.01), increased Child-Pugh score (p < 0.01), and R1 margin status (p = 0.05). Neoadjuvant chemotherapy correlated with lower readmission risk (p = 0.045). Readmissions didn't significantly impact five-year survival (p = 0.42) but increased fixed indirect hospital costs (p < 0.01).
Conclusions: Readmission post-robotic hepatectomy correlates with hypertension, higher Child-Pugh scores, and R1 margins. The use of neoadjuvant chemotherapy was associated with a lower admission rate due to less diffuse liver disease in these patients. While not affecting survival, readmissions elevate healthcare costs.
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http://dx.doi.org/10.1016/j.amjsurg.2024.03.014 | DOI Listing |
Ann Surg Open
December 2024
Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Objective: To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).
Background: Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.
Hepatobiliary Surg Nutr
December 2024
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
The robotic platform enables surgeons to operate with a similar level of freedom and control as in open surgery, while still providing the patient with the benefits of a minimally invasive approach. More centres continue to adopt robotic liver surgery however standardized training materials and consensus on the surgical technique are currently lacking. The availability of a standardized surgical protocol could benefit the further dissemination of the robotic approach while promoting safe and effective operating techniques.
View Article and Find Full Text PDFJ Robot Surg
December 2024
Hepato-Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.
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 PDFNorth Clin Istanb
November 2024
Department of General Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkiye.
Transplantation
December 2024
Department of Abdominal Organ Transplant and Hepatobiliary Surgery, Columbia University Irving Medical Center, New York, NY.
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