ロボット支援下肝切除術の現状
肝臓領域での低侵襲手術として腹腔鏡下肝切除術が定着してきた．2022年4月にロボット支援下肝切除術が保険収載され，安全な導入のため，厳格な施設基準および日本肝胆膵外科学会と日本内視鏡外科学会からの指針が提言され，学会認定プロクターの基準を定めている．ロボットでの精密な手術手技は，より安全性の高い肝切除術を実施できることが期待されている．一方でロボット手技のlearning curveの克服，短期・長期成績の観点からの前向き症例登録によるエビデンスの確立など，ロボット支援下肝切除術の普及にむけての課題は多い．...
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| Published in | 肝臓 Vol. 64; no. 12; pp. 595 - 602 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本肝臓学会
01.12.2023
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0451-4203 1881-3593 |
| DOI | 10.2957/kanzo.64.595 |
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| Abstract | 肝臓領域での低侵襲手術として腹腔鏡下肝切除術が定着してきた．2022年4月にロボット支援下肝切除術が保険収載され，安全な導入のため，厳格な施設基準および日本肝胆膵外科学会と日本内視鏡外科学会からの指針が提言され，学会認定プロクターの基準を定めている．ロボットでの精密な手術手技は，より安全性の高い肝切除術を実施できることが期待されている．一方でロボット手技のlearning curveの克服，短期・長期成績の観点からの前向き症例登録によるエビデンスの確立など，ロボット支援下肝切除術の普及にむけての課題は多い． |
|---|---|
| AbstractList | 肝臓領域での低侵襲手術として腹腔鏡下肝切除術が定着してきた．2022年4月にロボット支援下肝切除術が保険収載され，安全な導入のため，厳格な施設基準および日本肝胆膵外科学会と日本内視鏡外科学会からの指針が提言され，学会認定プロクターの基準を定めている．ロボットでの精密な手術手技は，より安全性の高い肝切除術を実施できることが期待されている．一方でロボット手技のlearning curveの克服，短期・長期成績の観点からの前向き症例登録によるエビデンスの確立など，ロボット支援下肝切除術の普及にむけての課題は多い． |
| Author | 吉住, 朋晴 伊藤, 心二 |
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| References | 20) Chiow AKH, Fuks D, Choi GH, et al. International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior sectionectomy. Br J Surg 2021; 108: 1513-1520 doi: 10.1093/bjs/znab321 10) Fretland ÅA, Dagenborg VJ, Bjørnelv GMW, et al. Laparoscopic Versus Open Resection for Colorectal Liver Metastases: The OSLO-COMET Randomized Controlled Trial. Ann Surg 2018; 267: 199-207 doi: 10.1097/SLA.0000000000002353 21) Chong CC, Fuks D, Lee KF, et al. Propensity Score-Matched Analysis Comparing Robotic and Laparoscopic Right and Extended Right Hepatectomy. JAMA Surg 2022; 157: 436-444 doi: 10.1001/jamasurg.2022.0161 6) Tomino T, Itoh S, Fujita N, et al. Clinical association between intraoperative indocyanine green fluorescence imaging pattern, preoperative Gd-EOB-DTPA-enhanced magnetic resonance imaging findings, and histological differentiation in hepatocellular carcinoma. Hepatol Res 2023; 53: 723-736 doi: 10.1111/hepr.13902 7) Kikuchi K, Suda K, Shibasaki S, et al. Challenges in improving the minimal invasiveness of the surgical treatment for gastric cancer using robotic technology. Ann Gastroenterol Surg 2021; 5: 604-613 doi: 10.1002/ags3.12463 17) Gavriilidis P, Roberts KJ, Aldrighetti L, et al. A comparison between robotic, laparoscopic and open hepatectomy: A systematic review and network meta-analysis. Eur J Surg Oncol 2020; 46: 1214-1224 doi: 10.1016/j.ejso.2020.03.227 15) Vining CC, Kuchta K, Al Abbas AI, et al. Bile leak incidence, risk factors and associated outcomes in patients undergoing hepatectomy: a contemporary NSQIP propensity matched analysis. Surg Endosc 2022; 36: 5710-5723 doi: 10.1007/s00464-021-08938-5 2) Wakabayashi G, Sasaki A, Nishizuka S, et al. Our initial experience with robotic hepato-biliary-pancreatic surgery. J Hepatobiliary Pancreat Sci 2011; 18: 481-487 doi: 10.1007/s00534-011-0388-3 13) Zhu P, Liao W, Zhang WG, et al. A Prospective Study Using Propensity Score Matching to Compare Long-term Survival Outcomes After Robotic-assisted, Laparoscopic, or Open Liver Resection for Patients With BCLC Stage 0-A Hepatocellular Carcinoma. Ann Surg 2023; 277: e103-e111 doi: 10.1097/SLA.0000000000005380 23) Kato Y, Sugioka A, Kojima M, et al. Initial experience with robotic liver resection: Audit of 120 consecutive cases at a single center and comparison with open and laparoscopic approaches. J Hepatobiliary Pancreat Sci 2023; 30: 72-90 doi: 10.1002/jhbp.1206 19) Kadam P, Sutcliffe RP, Scatton O, et al. An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments. J Hepatobiliary Pancreat Sci 2022; 29: 843-854 doi: 10.1002/jhbp.1149 4) 日本肝胆膵外科学会. ロボット支援肝切除術導入に関して. http://www.jshbps.jp/modules/office/index.php?content_id=19 8) Notarnicola M, Felli E, Roselli S, et al. Laparoscopic liver resection in elderly patients: systematic review and meta-analysis. Surg Endosc 2019; 33: 2763-2773 doi: 10.1007/s00464-019-06840-9 14) Di Benedetto F, Magistri P, Di Sandro S, et al. Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma. JAMA Surg 2023; 158: 46-54 doi: 10.1001/jamasurg.2022.5697 18) Ciria R, Berardi G, Alconchel F, et al. The impact of robotics in liver surgery: A worldwide systematic review and short-term outcomes meta-analysis on 2,728 cases. J Hepatobiliary Pancreat Sci 2022; 29: 181-197 doi: 10.1002/jhbp.869 1) Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital. Arch Surg 2003; 138: 777-784 doi: 10.1001/archsurg.138.7.777 9) Xiangfei M, Yinzhe X, Yingwei P, et al. Open versus laparoscopic hepatic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Surg Endosc 2019; 33: 2396-2418 doi: 10.1007/s00464-019-06781-3 3) 厚生労働省保健局医療課. 特掲診療料の施設基準等及びその届出に関する手続きの取扱いについて. 保医発0304号第3号. https://www.mhlw.go.jp/content/12404000/001080631.pdf 22) Liu Q, Zhang W, Zhao JJ, et al. Propensity-score Matched and Coarsened-exact Matched Analysis Comparing Robotic and Laparoscopic Major Hepatectomies: An International Multicenter Study of 4822 Cases. Ann Surg 2023; 278: 969-975 doi: 10.1097/SLA.0000000000005855 24) Nomi T, Fuks D, Kawaguchi Y, et al. Learning curve for laparoscopic major hepatectomy. Br J Surg 2015; 102: 796-804 doi: 10.1002/bjs.9798 11) Kamel MK, Tuma F, Keane CA, et al. National Trends and Perioperative Outcomes of Robotic-assisted Hepatectomy in the USA: A Propensity-score Matched Analysis from the National Cancer Database. World J Surg 2022; 46: 189-196 doi: 10.1007/s00268-021-06315-w 16) Vining CC, Al Abbas AI, Kuchta K, et al. Risk factors and outcomes in patients undergoing minimally invasive hepatectomy with unplanned conversion: a contemporary NSQIP analysis. HPB (Oxford) 2023; 25: 577-588 doi: 10.1016/j.hpb.2023.01.018 5) Itoh S, Tomiyama T, Morinaga A, et al. Clinical effects of the use of the indocyanine green fluorescence imaging technique in laparoscopic partial liver resection. Ann Gastroenterol Surg 2022; 6: 688-694 doi: 10.1002/ags3.12563 25) Chen PD, Wu CY, Hu RH, et al. Robotic major hepatectomy: Is there a learning curve? Surgery 2017; 161: 642-649 doi: 10.1016/j.surg.2016.09.025 12) Duong LM, Cai H, Shrubsole MJ, et al. Outcomes of robotic-assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma. Cancer 2022; 128: 762-769 doi: 10.1002/cncr.33979 |
| References_xml | – reference: 3) 厚生労働省保健局医療課. 特掲診療料の施設基準等及びその届出に関する手続きの取扱いについて. 保医発0304号第3号. https://www.mhlw.go.jp/content/12404000/001080631.pdf – reference: 14) Di Benedetto F, Magistri P, Di Sandro S, et al. Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma. JAMA Surg 2023; 158: 46-54 doi: 10.1001/jamasurg.2022.5697 – reference: 25) Chen PD, Wu CY, Hu RH, et al. Robotic major hepatectomy: Is there a learning curve? Surgery 2017; 161: 642-649 doi: 10.1016/j.surg.2016.09.025 – reference: 4) 日本肝胆膵外科学会. ロボット支援肝切除術導入に関して. http://www.jshbps.jp/modules/office/index.php?content_id=19 – reference: 22) Liu Q, Zhang W, Zhao JJ, et al. Propensity-score Matched and Coarsened-exact Matched Analysis Comparing Robotic and Laparoscopic Major Hepatectomies: An International Multicenter Study of 4822 Cases. Ann Surg 2023; 278: 969-975 doi: 10.1097/SLA.0000000000005855 – reference: 16) Vining CC, Al Abbas AI, Kuchta K, et al. Risk factors and outcomes in patients undergoing minimally invasive hepatectomy with unplanned conversion: a contemporary NSQIP analysis. HPB (Oxford) 2023; 25: 577-588 doi: 10.1016/j.hpb.2023.01.018 – reference: 24) Nomi T, Fuks D, Kawaguchi Y, et al. Learning curve for laparoscopic major hepatectomy. Br J Surg 2015; 102: 796-804 doi: 10.1002/bjs.9798 – reference: 17) Gavriilidis P, Roberts KJ, Aldrighetti L, et al. A comparison between robotic, laparoscopic and open hepatectomy: A systematic review and network meta-analysis. Eur J Surg Oncol 2020; 46: 1214-1224 doi: 10.1016/j.ejso.2020.03.227 – reference: 1) Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital. Arch Surg 2003; 138: 777-784 doi: 10.1001/archsurg.138.7.777 – reference: 8) Notarnicola M, Felli E, Roselli S, et al. Laparoscopic liver resection in elderly patients: systematic review and meta-analysis. Surg Endosc 2019; 33: 2763-2773 doi: 10.1007/s00464-019-06840-9 – reference: 12) Duong LM, Cai H, Shrubsole MJ, et al. Outcomes of robotic-assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma. Cancer 2022; 128: 762-769 doi: 10.1002/cncr.33979 – reference: 13) Zhu P, Liao W, Zhang WG, et al. A Prospective Study Using Propensity Score Matching to Compare Long-term Survival Outcomes After Robotic-assisted, Laparoscopic, or Open Liver Resection for Patients With BCLC Stage 0-A Hepatocellular Carcinoma. Ann Surg 2023; 277: e103-e111 doi: 10.1097/SLA.0000000000005380 – reference: 7) Kikuchi K, Suda K, Shibasaki S, et al. Challenges in improving the minimal invasiveness of the surgical treatment for gastric cancer using robotic technology. Ann Gastroenterol Surg 2021; 5: 604-613 doi: 10.1002/ags3.12463 – reference: 20) Chiow AKH, Fuks D, Choi GH, et al. International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior sectionectomy. Br J Surg 2021; 108: 1513-1520 doi: 10.1093/bjs/znab321 – reference: 15) Vining CC, Kuchta K, Al Abbas AI, et al. Bile leak incidence, risk factors and associated outcomes in patients undergoing hepatectomy: a contemporary NSQIP propensity matched analysis. Surg Endosc 2022; 36: 5710-5723 doi: 10.1007/s00464-021-08938-5 – reference: 5) Itoh S, Tomiyama T, Morinaga A, et al. Clinical effects of the use of the indocyanine green fluorescence imaging technique in laparoscopic partial liver resection. Ann Gastroenterol Surg 2022; 6: 688-694 doi: 10.1002/ags3.12563 – reference: 10) Fretland ÅA, Dagenborg VJ, Bjørnelv GMW, et al. Laparoscopic Versus Open Resection for Colorectal Liver Metastases: The OSLO-COMET Randomized Controlled Trial. Ann Surg 2018; 267: 199-207 doi: 10.1097/SLA.0000000000002353 – reference: 6) Tomino T, Itoh S, Fujita N, et al. Clinical association between intraoperative indocyanine green fluorescence imaging pattern, preoperative Gd-EOB-DTPA-enhanced magnetic resonance imaging findings, and histological differentiation in hepatocellular carcinoma. Hepatol Res 2023; 53: 723-736 doi: 10.1111/hepr.13902 – reference: 21) Chong CC, Fuks D, Lee KF, et al. Propensity Score-Matched Analysis Comparing Robotic and Laparoscopic Right and Extended Right Hepatectomy. JAMA Surg 2022; 157: 436-444 doi: 10.1001/jamasurg.2022.0161 – reference: 18) Ciria R, Berardi G, Alconchel F, et al. The impact of robotics in liver surgery: A worldwide systematic review and short-term outcomes meta-analysis on 2,728 cases. J Hepatobiliary Pancreat Sci 2022; 29: 181-197 doi: 10.1002/jhbp.869 – reference: 9) Xiangfei M, Yinzhe X, Yingwei P, et al. Open versus laparoscopic hepatic resection for hepatocellular carcinoma: a systematic review and meta-analysis. Surg Endosc 2019; 33: 2396-2418 doi: 10.1007/s00464-019-06781-3 – reference: 11) Kamel MK, Tuma F, Keane CA, et al. National Trends and Perioperative Outcomes of Robotic-assisted Hepatectomy in the USA: A Propensity-score Matched Analysis from the National Cancer Database. World J Surg 2022; 46: 189-196 doi: 10.1007/s00268-021-06315-w – reference: 19) Kadam P, Sutcliffe RP, Scatton O, et al. An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments. J Hepatobiliary Pancreat Sci 2022; 29: 843-854 doi: 10.1002/jhbp.1149 – reference: 23) Kato Y, Sugioka A, Kojima M, et al. Initial experience with robotic liver resection: Audit of 120 consecutive cases at a single center and comparison with open and laparoscopic approaches. J Hepatobiliary Pancreat Sci 2023; 30: 72-90 doi: 10.1002/jhbp.1206 – reference: 2) Wakabayashi G, Sasaki A, Nishizuka S, et al. Our initial experience with robotic hepato-biliary-pancreatic surgery. J Hepatobiliary Pancreat Sci 2011; 18: 481-487 doi: 10.1007/s00534-011-0388-3 |
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