The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review
BackgroundThe role of robotic surgery (RS) for hilar cholangiocarcinoma (HC) is under investigation. Surgical resection is the only curative modality of treatment but extremely complex and high risk of morbidity and mortality may occur. The aim of this study is to perform a systematic review of peri...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1001838/full |
| _version_ | 1818032895084724224 |
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| author | Alberto Brolese Marta Rigoni Alessio Pasquale Giovanni Viel Marco Brolese Francesco Antonio Ciarleglio |
| author_facet | Alberto Brolese Marta Rigoni Alessio Pasquale Giovanni Viel Marco Brolese Francesco Antonio Ciarleglio |
| author_sort | Alberto Brolese |
| collection | DOAJ |
| description | BackgroundThe role of robotic surgery (RS) for hilar cholangiocarcinoma (HC) is under investigation. Surgical resection is the only curative modality of treatment but extremely complex and high risk of morbidity and mortality may occur. The aim of this study is to perform a systematic review of perioperative and oncological outcomes of RS for HC, across a comprehensive range of outcomes reported in recent literature.Materials and MethodsPRISMA checklist was used as a basis for writing the systematic review and studies’ selection. Literature documenting RS for HC was analyzed by searching PubMed and Cochrane Library from 2009 to May 2022. The search terms, either independently or in combination, were used according to PICOT framework. The target population are patients treated with robotic surgical approach for HC.Results12 studies with 109 patients were included after screening process. The Bismuth classification in all series except one was: 21 type I, 7 type II, 12 type IIIa, 26 type IIIb and 4 type IV. Mean operative time for a total of 21 patients was 644 minutes. Other two case series reported a median operative time of 375 with a console time of 276 minutes. Mean blood loss for case reports and two case series was 662 milliliters. Blood transfusion rate for all operation was 33.3%. Overall Conversion rate was 2.8%. Pooled post operative morbidity and mortality was 39.8% and 1.8% respectively. Mean LOS for case reports and one case series for a total of 17 patients was 16 days. R0 resection rate for the 11 papers was 74.3%. Seven out of 12 studies reported on the oncological follow up: median observation time ranged from 5 to 60 months, recurrence rate was 52.6% (range 0-90%) reported only in 19 patients (10/19).ConclusionsRS for HC was feasible and safe. However, although this systematic review could not be conclusive in most of the analyzed items, RS for the treatment of HC could represent the best tool for a future meticulous and precision surgery. The review’s results certainly indicate that further research in urgently is required on this field. |
| first_indexed | 2024-12-10T06:14:38Z |
| format | Article |
| id | doaj.art-342f99333d114190a152ba754732151b |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T06:14:38Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-342f99333d114190a152ba754732151b2022-12-22T01:59:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.10018381001838The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic reviewAlberto Brolese0Marta Rigoni1Alessio Pasquale2Giovanni Viel3Marco Brolese4Francesco Antonio Ciarleglio5Department of General Surgery and Hepato-Pancreato-Biliary (HPB) Unit – APSS, Trento, ItalyDepartment of Biomedical, Surgical and Dental Sciences, Faculty of Medicine and Surgery, University of Milan, Milan, ItalyDepartment of General Surgery and Hepato-Pancreato-Biliary (HPB) Unit – APSS, Trento, ItalyDepartment of General Surgery and Hepato-Pancreato-Biliary (HPB) Unit – APSS, Trento, ItalyDepartment of Surgery, University of Padua, Padua, ItalyDepartment of General Surgery and Hepato-Pancreato-Biliary (HPB) Unit – APSS, Trento, ItalyBackgroundThe role of robotic surgery (RS) for hilar cholangiocarcinoma (HC) is under investigation. Surgical resection is the only curative modality of treatment but extremely complex and high risk of morbidity and mortality may occur. The aim of this study is to perform a systematic review of perioperative and oncological outcomes of RS for HC, across a comprehensive range of outcomes reported in recent literature.Materials and MethodsPRISMA checklist was used as a basis for writing the systematic review and studies’ selection. Literature documenting RS for HC was analyzed by searching PubMed and Cochrane Library from 2009 to May 2022. The search terms, either independently or in combination, were used according to PICOT framework. The target population are patients treated with robotic surgical approach for HC.Results12 studies with 109 patients were included after screening process. The Bismuth classification in all series except one was: 21 type I, 7 type II, 12 type IIIa, 26 type IIIb and 4 type IV. Mean operative time for a total of 21 patients was 644 minutes. Other two case series reported a median operative time of 375 with a console time of 276 minutes. Mean blood loss for case reports and two case series was 662 milliliters. Blood transfusion rate for all operation was 33.3%. Overall Conversion rate was 2.8%. Pooled post operative morbidity and mortality was 39.8% and 1.8% respectively. Mean LOS for case reports and one case series for a total of 17 patients was 16 days. R0 resection rate for the 11 papers was 74.3%. Seven out of 12 studies reported on the oncological follow up: median observation time ranged from 5 to 60 months, recurrence rate was 52.6% (range 0-90%) reported only in 19 patients (10/19).ConclusionsRS for HC was feasible and safe. However, although this systematic review could not be conclusive in most of the analyzed items, RS for the treatment of HC could represent the best tool for a future meticulous and precision surgery. The review’s results certainly indicate that further research in urgently is required on this field.https://www.frontiersin.org/articles/10.3389/fonc.2022.1001838/fullhilar cholangiocarcinomaKlatskin tumorrobotic liver resectionliver resectionbiliary tumor |
| spellingShingle | Alberto Brolese Marta Rigoni Alessio Pasquale Giovanni Viel Marco Brolese Francesco Antonio Ciarleglio The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review Frontiers in Oncology hilar cholangiocarcinoma Klatskin tumor robotic liver resection liver resection biliary tumor |
| title | The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review |
| title_full | The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review |
| title_fullStr | The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review |
| title_full_unstemmed | The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review |
| title_short | The role of robotic surgery for the treatment of hilar cholangiocarcinoma: A systematic review |
| title_sort | role of robotic surgery for the treatment of hilar cholangiocarcinoma a systematic review |
| topic | hilar cholangiocarcinoma Klatskin tumor robotic liver resection liver resection biliary tumor |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1001838/full |
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