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Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results

Background: Robotic adrenalectomy offers several clinical benefits if compared with laparoscopic adrenalectomy; however, its superiority is still under debate. The aim of this study was the investigation of differences between the two techniques, and a comparison when approaching right or left side...

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Autores principales: Piccoli, Micaela, Pecchini, Francesca, Serra, Francesco, Nigro, Casimiro, Colli, Giovanni, Gozzo, Davide, Zirilli, Lucia, Madeo, Bruno, Rochira, Vincenzo, Mullineris, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060876/
https://www.ncbi.nlm.nih.gov/pubmed/33450160
http://dx.doi.org/10.1089/lap.2020.0839
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author Piccoli, Micaela
Pecchini, Francesca
Serra, Francesco
Nigro, Casimiro
Colli, Giovanni
Gozzo, Davide
Zirilli, Lucia
Madeo, Bruno
Rochira, Vincenzo
Mullineris, Barbara
author_facet Piccoli, Micaela
Pecchini, Francesca
Serra, Francesco
Nigro, Casimiro
Colli, Giovanni
Gozzo, Davide
Zirilli, Lucia
Madeo, Bruno
Rochira, Vincenzo
Mullineris, Barbara
author_sort Piccoli, Micaela
collection PubMed
description Background: Robotic adrenalectomy offers several clinical benefits if compared with laparoscopic adrenalectomy; however, its superiority is still under debate. The aim of this study was the investigation of differences between the two techniques, and a comparison when approaching right or left side adrenal lesions was further conducted. Materials and Methods: All patients undergoing laparoscopic and robotic unilateral adrenalectomy at our institution from January 2006 to December 2019 were collected and retrospectively analyzed. Statistical analysis was conducted; differences between the two cohorts were reported. Results: A total of 160 cases were included (84 patients in laparoscopic adrenalectomy-group [LA-g] 76 cases in robotic adrenalectomy-group [RA-g]). The groups were homogeneous for demographic data. No intraoperative complications were reported; mean amount of intraoperative blood loss was comparable. No cases of conversion to open surgery were required. RA-g presented a longer operative time than LA-g for right adrenalectomy (P = .05), no differences were noted for left side (P = .187). Overall morbidity was 21% for LA-g and 10.5% for RA-g (P = .087), with an inferior rate of surgical complications for RA-g (P = .024), and for robotic left adrenalectomy than robotic right procedure (P = .03). Length of hospital stay was shorter for RA-g (P = .005). Conclusions: Robotic adrenalectomy presents similar outcomes as laparoscopic approach with some benefits for selected cases. Left adrenal lesions seem to receive greater advantages from robotic technique. Large randomized controlled trials are required to determine the role of robotic adrenal surgery and if the indication can be standardized based on the laterality of adrenal procedure.
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spelling pubmed-80608762021-04-22 Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results Piccoli, Micaela Pecchini, Francesca Serra, Francesco Nigro, Casimiro Colli, Giovanni Gozzo, Davide Zirilli, Lucia Madeo, Bruno Rochira, Vincenzo Mullineris, Barbara J Laparoendosc Adv Surg Tech A Full Reports Background: Robotic adrenalectomy offers several clinical benefits if compared with laparoscopic adrenalectomy; however, its superiority is still under debate. The aim of this study was the investigation of differences between the two techniques, and a comparison when approaching right or left side adrenal lesions was further conducted. Materials and Methods: All patients undergoing laparoscopic and robotic unilateral adrenalectomy at our institution from January 2006 to December 2019 were collected and retrospectively analyzed. Statistical analysis was conducted; differences between the two cohorts were reported. Results: A total of 160 cases were included (84 patients in laparoscopic adrenalectomy-group [LA-g] 76 cases in robotic adrenalectomy-group [RA-g]). The groups were homogeneous for demographic data. No intraoperative complications were reported; mean amount of intraoperative blood loss was comparable. No cases of conversion to open surgery were required. RA-g presented a longer operative time than LA-g for right adrenalectomy (P = .05), no differences were noted for left side (P = .187). Overall morbidity was 21% for LA-g and 10.5% for RA-g (P = .087), with an inferior rate of surgical complications for RA-g (P = .024), and for robotic left adrenalectomy than robotic right procedure (P = .03). Length of hospital stay was shorter for RA-g (P = .005). Conclusions: Robotic adrenalectomy presents similar outcomes as laparoscopic approach with some benefits for selected cases. Left adrenal lesions seem to receive greater advantages from robotic technique. Large randomized controlled trials are required to determine the role of robotic adrenal surgery and if the indication can be standardized based on the laterality of adrenal procedure. Mary Ann Liebert, Inc., publishers 2021-04-01 2021-04-01 /pmc/articles/PMC8060876/ /pubmed/33450160 http://dx.doi.org/10.1089/lap.2020.0839 Text en © Micaela Piccoli et al. 2021; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by-nc/4.0/This Open Access article is distributed under the terms of the Creative Commons Attribution Noncommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Full Reports
Piccoli, Micaela
Pecchini, Francesca
Serra, Francesco
Nigro, Casimiro
Colli, Giovanni
Gozzo, Davide
Zirilli, Lucia
Madeo, Bruno
Rochira, Vincenzo
Mullineris, Barbara
Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title_full Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title_fullStr Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title_full_unstemmed Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title_short Robotic Versus Laparoscopic Adrenalectomy: Pluriannual Experience in a High-Volume Center Evaluating Indications and Results
title_sort robotic versus laparoscopic adrenalectomy: pluriannual experience in a high-volume center evaluating indications and results
topic Full Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060876/
https://www.ncbi.nlm.nih.gov/pubmed/33450160
http://dx.doi.org/10.1089/lap.2020.0839
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