Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2020; 26(21): 2831-2838
Published online Jun 7, 2020. doi: 10.3748/wjg.v26.i21.2831
Successful robotic radical resection of hepatic echinococcosis located in posterosuperior liver segments
Zhi-Ming Zhao, Zhu-Zeng Yin, Yuan Meng, Nan Jiang, Zhi-Gang Ma, Li-Chao Pan, Xiang-Long Tan, Xiong Chen, Rong Liu
Zhi-Ming Zhao, Zhu-Zeng Yin, Nan Jiang, Li-Chao Pan, Xiang-Long Tan, Rong Liu, The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Yuan Meng, Zhi-Gang Ma, Xiong Chen, The Department of Hepatobiliary Surgery, The People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, Xinjiang Uygur Autonomous Region, China
Author contributions: Zhao ZM and Yin ZZ contribute equally to this work; Zhao ZM and Yin ZZ analyzed and interpreted data and wrote the article; Meng Y, Jiang N, Ma ZG, Pan LC and Tan XL collected the data; Chen X and Liu R designed the study.
Institutional review board statement: The study was approved by the Institutional Review Board of the Chinese People's Liberation Army General Hospital (S2016-098-02).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: Due to the sensitive nature of the questions asked in this study, survey respondents were assured raw data would remain confidential and would not be shared.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Rong Liu, MD, PhD, Professor, The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People’s Liberation Army General Hospital, No. 28 Fuxing Road, Beijing 100853, China. liurong301@126.com
Received: March 22, 2020
Peer-review started: March 22, 2020
First decision: April 9, 2020
Revised: April 23, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: June 7, 2020
Abstract
BACKGROUND

Radical resection is an important treatment method for hepatic echinococcosis. The posterosuperior segments of the liver remain the most challenging region for laparoscopic or robotic hepatectomy.

AIM

To demonstrate the safety and preliminary experience of robotic radical resection of cystic and alveolar echinococcosis in posterosuperior liver segments.

METHODS

A retrospective analysis was conducted on the clinical data of 5 patients with a median age of 37 years (21-56 years) with cystic and alveolar echinococcosis in difficult liver lesions admitted to two centers from September to December 2019. The surgical methods included total pericystectomy, segmental hepatectomy, or hemihepatectomy.

RESULTS

Among the 5 patients, 4 presented with cystic echinococcosis and 1 presented with alveolar echinococcosis, all of whom underwent robotic radical operation successfully without conversion to laparotomy. Total caudate lobectomy was performed in 2 cases, hepatectomy of segment VII in 1 case, total pericystectomy of segment VIII in 1 case, and right hemihepatectomy in 1 case. Operation time was 225 min (175-300 min); blood loss was 100 mL (50-600 mL); and postoperative hospital stay duration was 10 d (5-19 d). The Clavien-Dindo complication grade was I in 4 cases and II in 1 case. No recurrence of echinococcosis was found in any patient at the 3 mo of follow-up.

CONCLUSION

Robotic radical surgery for cystic and selected alveolar echinococcosis in posterosuperior liver segments is safe and feasible.

Keywords: Cystic echinococcosis, Alveolar echinococcosis, Robotic surgery, Posterosuperior segment, Caudate lobe, Liver

Core tip: This study aimed to elucidate the safety and preliminary experience of robotic radical resection of cystic and alveolar echinococcosis in posterosuperior liver segments. Our results demonstrated that robotic transabdominal approach can be an option of treatment and feasible for resection of cystic and selected alveolar echinococcosis located in the posterosuperior hepatic segments.