Long-term and immediate results of robot-assisted resection of liver and bile ducts in portal cholangiocarcinoma
M. G. Efanov,
R. B. Alikhanov,
I. V. Kazakov,
A. A. Koroleva,
A. N. Vankovich,
O. V. Melekhina,
Y. V. Kulezneva,
P. V. Tarakanov,
M. N. Kaminsky,
N. N. Britskaia,
D. V. Fisenko,
V. V. Tsvirkun,
I. E. Khatkov https://doi.org/10.16931/1995-5464.2022-4-31-40
Abstract
Aim. To compare the immediate and long-term results of robot-assisted and open resection of the liver and bile ducts for portal cholangiocarcinoma.
Materials and methods. The retrospective study was based upon the results of open and robot-assisted resections in 2013–2021. Patients without signs of the tumor invasion into the great vessels requiring resection and reconstruction were selected for the robot-assisted resection of the liver and bile ducts. Propensity score matching was carried out within the immediate environment in the ratio 1:2 for five covariates.
Results. The results of 147 open resections of the liver and bile ducts and 17 robot-assisted resections were compared. After propensity score matching, the authors compared 33 open and 17 robot-assisted resections. Before and after propensity score matching, statistically significant differences were obtained only in the longer duration of robotassisted resections. Right hepatectomy and caudal resection were performed more frequently in the group of patients with robot-assisted interventions, but without significant differences. The authors noted a tendency to a higher frequency of R0 and a lower 90-day mortality rate after robot-assisted interventions, with no differences in the rate and nature of complications, as well as in duration of hospitalization. Survival did not differ before and after propensity score matching. After open and robot-assisted interventions the overall five-year survival rates before propensity score matching were 32% and 67%, after propensity score matching the overall four-year survival rates accounted for 62% and 63%.
Conclusion. Analysis of the first experience shows a tendency to improve some immediate outcomes without worsening survival. Robot-assisted resection of the liver and bile ducts can be applied, without limitation of oncologic principles, in selected patients with portal cholangiocarcinoma if the resection is performed in specialized hepatological centers, where specialists have experience in minimally invasive surgery.
About the Authors
M. G. Efanov
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Mikhail G. Efanov – Doct. of Sci. (Med.), Head of the Department of Hepato-pancreato-biliary Surgery
86, Sh. Entuziastov, Moscow, 111123
R. B. Alikhanov
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Ruslan B. Alikhanov – Cand. of Sci. (Med.), Head of the Department of Hepato-pancreato-biliary Surgery
86, Sh. Entuziastov, Moscow, 111123
I. V. Kazakov
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Ivan V. Kazakov – Cand. of Sci. (Med.), Senior Researcher of the Department f Hepato-pancreato-biliary Surgery
86, Sh. Entuziastov, Moscow, 111123
A. A. Koroleva
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Anna A. Koroleva – Cand. of Sci. (Med.), Senior Researcher of the Department of Hepato-pancreato-biliary Surgery; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
A. N. Vankovich
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Andrey N. Vankovich – Cand. of Sci. (Med.), Researcher of the Department of Hepato-pancreato-biliary Surgery; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
O. V. Melekhina
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Olga V. Melekhina – Cand. of Sci. (Med.), Senior Researcher of the Department of Radiological Methods of Diagnosis and Treatment; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
Y. V. Kulezneva
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Yuliya V. Kulezneva – Doct. of Sci. (Med.), Professor, Head of the Department of Radiological Methods of Diagnosis and Treatment; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
P. V. Tarakanov
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Pavel V. Tarakanov – Cand. of Sci. (Med.), Researcher of the Department of Hepato-pancreato-biliary Surgery; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
M. N. Kaminsky
Far Eastern State Medical University
Russian Federation
Russian Federation
Maxim N. Kaminsky – Cand. of Sci. (Med.), Assistant, Department of General and Clinical Surgery
35, Muravyova-Amurskogo str., Khabarovsk, 680000
N. N. Britskaia
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Natalia N. Britskaia – Cand. of Sci. (Med.), Doctoral Candidate; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
D. V. Fisenko
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Denis V. Fisenko – Researcher the Department of Hepato-pancreato-biliary Surgery; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
V. V. Tsvirkun
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Victor V. Tsvirkun – Doct. of Sci. (Med.), Professor, Chief Researcher; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
I. E. Khatkov
Moscow Clinical Scientific Center named after A.S. Loginov
Russian Federation
Russian Federation
Igor E. Khatkov – Doct. of Sci. (Med.), Professor, Academician of Russian Academy of Sciences, Director; Department of Health of Moscow
86, Sh. Entuziastov, Moscow, 111123
Phone: +7-916-105-88-30
References
1. Efanov M.G., Alikhanov R.B., Kazakov I.V., Vankovich A.N., Melekhina O.V., Kulezneva Yu.V., Elizarova N.I., Koroleva A.A., Kovalenko D.E., Tsvirkun V.V. Robot-assisted and open resections for perihilar cholangiocarcinoma. Comparative analysis of the immediate outcomes. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2020; 25 (4): 60 - 70. https://doi.org/10.16931/1995-5464.2020460-70 (In Russian)
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For citations:
Efanov M.G., Alikhanov R.B., Kazakov I.V., Koroleva A.A., Vankovich A.N., Melekhina O.V., Kulezneva Y.V., Tarakanov P.V., Kaminsky M.N., Britskaia N.N., Fisenko D.V., Tsvirkun V.V., Khatkov I.E. Long-term and immediate results of robot-assisted resection of liver and bile ducts in portal cholangiocarcinoma. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2022;27(4):31-40. (In Russ.) https://doi.org/10.16931/1995-5464.2022-4-31-40
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