Robotic assisted versus pure laparoscopic surgery of the adrenal glands: a case-control study comparing surgical techniques

作者：Morelli Luca^*; Tartaglia Dario; Bronzoni Jessica; Palmeri Matteo; Guadagni Simone; Di Franco Gregorio; Gennai Andrea; Bianchini Matteo; Bastiani Luca; Moglia Andrea; Ferrari Vincenzo; Fommei Enza; Pietrabissa Andrea; Di Candio Giulio; Mosca Franco

来源：Langenbeck's Archives of Surgery, 2016, 401(7): 999-1006.

DOI：10.1007/s00423-016-1494-0

• Total adrenalectomy
• Laparoscopy
• Robotics
• Case-matched study
• Retrospective

The role of the da Vinci Robotic System (A (R)) in adrenal gland surgery is not yet well defined. The goal of this study was to compare robotic-assisted surgery with pure laparoscopic surgery in a single center.
One hundred and 16 patients underwent minimally invasive adrenalectomies in our department between June 1994 and December 2014, 41 of whom were treated with a robotic-assisted approach (robotic adrenalectomy, RA). Patients who underwent RA were matched according to BMI, age, gender, and nodule dimensions, and compared with 41 patients who had undergone laparoscopic adrenalectomies (LA). Statistical analysis was performed using the Student's t test for independent samples, and the relationship between the operative time and other covariates were evaluated with a multivariable linear regression model. P < 0.05 was considered significant.
Mean operative time was significantly shorter in the RA group compared to the LA group. The subgroup analysis showed a shorter mean operative time in the RA group in patients with nodules aeyen6 cm, BMI aeyen 30 kg/m(2) and in those who had previous abdominal surgery (p < 0.05). Results from the multiple regression model confirmed a shorter mean operative time with RA with nodules aeyen6 cm (p = 0.010). Conversion rate and postoperative complications were 2.4 and 4.8 % in the LA group and 0 and 4.8 % in the RA group.
In our experience, RA shows potential benefits compared to classic LA, in particular on patients with nodules aeyen6 cm, BMI aeyen 30 kg/m2, and with previous abdominal surgery.

• 出版日期2016-11