Long-Term Results of Single-Site Robotic Cholecystectomy

SAGES, Montreal, Kanada, 29 Mart - 01 Nisan 2023, cilt.47, ss.425-426, (Özet Bildiri)

Objective: To evaluate long-term complications and incisional hernia
rates after single-site robotic cholecystectomy.
Methods: All patients who underwent single-site robotic cholecystectomy
between February 2014 and December 2017 were reviewed.
Pre-, intra-, and postoperative variables were analyzed. Complications
were assessed using the Clavien–Dindo Classification (CD) and
Comprehensive Complication Index (CCI ) scoring system. Followup
consisted of a combination of telehealth visits, physical examination,
and imaging studies in order to assess for occurrence of
incisional hernias. Kaplan–Meier’s time-to-event analysis was performed
to calculate the estimated freedom from an incisional hernia.
Results: 211 patients who underwent SSRC were included.
Mean ± Standard Deviation (SD) for age and body mass index were
45 ± 16.6 years and 28 ± 5 kg/m2, respectively. 141 patients had an
American Society of Anesthesiologists score of 2. The median (interquartile
range) console time and skin-to-skin time were 18 (14–27)
and 38 (29–51) minutes, respectively. No intraoperative complications
or conversions to other approaches occurred in the cohort.
Pathology most commonly revealed chronic cholecystitis and
cholelithiasis (185 and 164 cases, respectively), with a fewer number
of acute cholecystitis (32). Over an average follow-up period of
77 months, nineteen (9%) patients experienced adverse postoperative
events. Of those, eleven were surgical site complications. Clavien–
Dindo grades were primarily CD-1 (3.3%) and CD-3B (3.8%) complications.
CCI scores ranged from 0 to 39.7. Two patients
underwent postoperative endoscopic retrograde cholangiopancreatography
(ERCP) due to suspicion for common bile duct stone;
however, both ERCPs were unremarkable. Eight (3.8%) patients
experienced an incisional hernia. Estimated hernia-free time was
found to be 100 months (95% confidence interval = 99–101) for the
cohort.
Conclusion: This is the first study to describe long-term follow-up in
single-site robotic cholecystectomy. In our experience, we demonstrated
a low incisional hernia rate and overall favorable outcomes.