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Not just minor resections: robotic approach for cystic echinococcosis of the liver

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Abstract

Introduction

Human echinococcosis is among the 17 neglected tropical diseases recognized by the World Health Organization. It is responsible for over $3 billion of health costs every year being endemic in large areas worldwide, and liver is affected in 70% of the cases. Surgery associated to medical treatment is the gold standard and robotic approach may be a valuable tool to achieve safe, parenchyma sparing resections.

Methods

We retrospectively analyzed the outcomes of patients that underwent robotic radical surgical treatment for hydatid liver disease, from prospectively maintained databases of three Italian centers.

Results

15 patients were included in this study, median age 51 years (24–76). 1 right hepatectomy, 2 left lateral sectionectomies, 5 segmentectomies (including 1 caudatectomy), 3 wedge resections and 5 cyst-pericystectomies were performed. Median estimated blood loss was of 100 ml (50–550 ml), and median operative time including docking was 210 min (95–590 min), with no need for conversion to open. Median hospital stay was 4 days, with only one readmission for fever. Only one patient experienced recurrence in a different liver segment.

Conclusions

In our experience, robotic approach for cystic echinococcosis of the liver proved to be a safe and effective strategy also in the so-called “difficult segments”, with short post-operative stay and quick return to daily activities, along with the absence of surgical site recurrences. To the best of our knowledge, this is the largest report of robotic approach to hydatid liver disease.

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, MO, Italy

    Paolo Magistri, Barbara Catellani, Giacomo Assirati, Cristiano Guidetti, Gian Piero Guerrini, Giuseppe Tarantino, Roberto Ballarin & Fabrizio Di Benedetto

  2. Department of Radiology, “Policlinico” University Hospital of Modena, 41124, Modena, MO, Italy

    Annarita Pecchi

  3. Department of Infectious Diseases, “Policlinico” University Hospital of Modena, 41124, Modena, MO, Italy

    Erica Franceschini & Mauro Codeluppi

  4. Division of Oncologic Surgery and Robotics, Azienda Ospedaliero-Universitaria Di Careggi, 50139, Florence, FI, Italy

    Benedetta Pesi & Andrea Coratti

  5. Department of Translational and New Technologies in Medicine and Surgery, University of Pisa, 56124, Pisa, Italy

    Simone Guadagni & Luca Morelli

Authors
  1. Paolo Magistri
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  2. Annarita Pecchi
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  3. Erica Franceschini
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  4. Benedetta Pesi
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  8. Cristiano Guidetti
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  9. Gian Piero Guerrini
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  11. Roberto Ballarin
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  13. Luca Morelli
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  14. Andrea Coratti
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  15. Fabrizio Di Benedetto
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Corresponding author

Correspondence to Fabrizio Di Benedetto.

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Magistri, P., Pecchi, A., Franceschini, E. et al. Not just minor resections: robotic approach for cystic echinococcosis of the liver. Infection 47, 973–979 (2019). https://doi.org/10.1007/s15010-019-01333-2

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  • DOI: https://doi.org/10.1007/s15010-019-01333-2

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