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Robotic-assisted versus laparoscopic approach of Bai-Jiang-style vagus nerve-preserving splenectomy and azygoportal disconnection.
- Source :
-
Updates in surgery [Updates Surg] 2022 Oct; Vol. 74 (5), pp. 1773-1780. Date of Electronic Publication: 2022 Jan 07. - Publication Year :
- 2022
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Abstract
- Robotic surgery has been widely accepted in many kinds of surgical procedures. Little is known about clinical effects of robotic-assisted splenectomy and azygoportal disconnection (RSD) for gastroesophageal variceal bleeding and secondary hypersplenism owing to cirrhotic portal hypertension. The aim of this study was to evaluate whether RSD is feasible and safe for patients with cirrhotic portal hypertension and whether RSD is superior to laparoscopic splenectomy and azygoportal disconnection (LSD). We retrospectively investigated the clinical effects of 50 patients with cirrhosis who underwent vagus nerve-preserving RSD (n = 20) and LSD (n = 30) between September 2020 and October 2021. We compared patients' demographic, intraoperative, and perioperative variables. RSD and LSD were successful in all patients. Operative time did not differ significantly between the RSD group and LSD group (151.15 ± 21.78 min vs. 144.50 ± 24.30 min, P > 0.05), but intraoperative blood loss were significantly reduced in the RSD group (61.00 ± 34.93 mL vs. 105.00 ± 68.77 mL, P < 0.05). No statistically significant differences were found regarding intraoperative allogeneic transfusion rate, visual analog scale pain score on the postoperative first day, time to first oral intake, initial passage of flatus, initial off-bed activity, postoperative hospital stay, and overall perioperative complication rate (all P > 0.05). In conclusion, RSD is not only a technically feasible and safe procedure but it was associated with less blood loss than LSD for cirrhotic portal hypertension with gastroesophageal variceal bleeding and secondary hypersplenism. Registered at researchregistery.com: trial registration number is researchregistry7244, date of registration October 10, 2021, registered retrospectively.<br /> (© 2022. Italian Society of Surgery (SIC).)
- Subjects :
- Humans
Gastrointestinal Hemorrhage complications
Gastrointestinal Hemorrhage surgery
Liver Cirrhosis surgery
Retrospective Studies
Splenectomy methods
Treatment Outcome
Vagus Nerve
Esophageal and Gastric Varices complications
Esophageal and Gastric Varices surgery
Hypersplenism complications
Hypersplenism surgery
Hypertension, Portal complications
Hypertension, Portal surgery
Laparoscopy methods
Robotic Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 2038-3312
- Volume :
- 74
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Updates in surgery
- Publication Type :
- Academic Journal
- Accession number :
- 34994944
- Full Text :
- https://doi.org/10.1007/s13304-022-01236-2