학술논문
Awake robotic liver surgery: A case report.
Document Type
Report
Author
Delvecchio A; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Pavone G; Unit of Anesthesia and Perioperative Medicine, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Conticchio M; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Piacente C; Unit of Anesthesia and Perioperative Medicine, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Varvara M; Unit of Anesthesia and Perioperative Medicine, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Ferraro V; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Stasi M; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Casella A; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Filippo R; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Tedeschi M; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Pullano C; Villa Pia Hospital, Rome 00151, Italy.; Inchingolo R; Unit of Interventional Radiology, 'F. Miulli' Regional General Hospital, Bari 70021, Italy. riccardoin@hotmail.it.; Delmonte V; Unit of Anesthesia and Perioperative Medicine, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.; Memeo R; Unit of Hepato-Pancreatic-Biliary Surgery, 'F. Miulli' Regional General Hospital, Bari 70021, Italy.
Source
Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101532473 Publication Model: Print Cited Medium: Print ISSN: 1948-9366 (Print) NLM ISO Abbreviation: World J Gastrointest Surg Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1948-9366
Abstract
Background: In recent years, minimally invasive liver resection has become a standard of care for liver tumors. Considering the need to treat increasingly fragile patients, general anesthesia is sometimes avoided due to respiratory complications. Therefore, surgical treatment with curative intent is abandoned in favor of a less invasive and less radical approach. Epidural anesthesia has been shown to reduce respiratory complications, especially in elderly patients with pre-existing lung disease.
Case Summary: A 77-year-old man with hepatitis-C-virus-related chronic liver disease underwent robotic liver resection for hepatocellular carcinoma. The patient was suffering from hypertension, diabetes and chronic obstructive pulmonary disease. The National Surgical Quality Improvement Program score for developing pneumonia was 9.2%. We planned a combined spinal-epidural anesthesia with conscious sedation to avoid general anesthesia. No modification of the standard surgical technique was necessary. Hemodynamics were stable and bleeding was minimal. The postoperative course was uneventful.
Conclusion: Robotic surgery in locoregional anesthesia with conscious sedation could be considered a safe and suitable approach in specialized centers and in selected patients.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
(©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
Case Summary: A 77-year-old man with hepatitis-C-virus-related chronic liver disease underwent robotic liver resection for hepatocellular carcinoma. The patient was suffering from hypertension, diabetes and chronic obstructive pulmonary disease. The National Surgical Quality Improvement Program score for developing pneumonia was 9.2%. We planned a combined spinal-epidural anesthesia with conscious sedation to avoid general anesthesia. No modification of the standard surgical technique was necessary. Hemodynamics were stable and bleeding was minimal. The postoperative course was uneventful.
Conclusion: Robotic surgery in locoregional anesthesia with conscious sedation could be considered a safe and suitable approach in specialized centers and in selected patients.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
(©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)