Awake robotic liver surgery:A case report  

作　　者：Antonella Delvecchio Gaetano Pavone Maria Conticchio Claudia Piacente Miriam Varvara Valentina Ferraro Matteo Stasi Annachiara Casella Rosalinda Filippo Michele Tedeschi Carmine Pullano Riccardo Inchingolo Vito Delmonte Riccardo Memeo 

机构地区：[1]Unit of Hepato-Pancreatic-Biliary Surgery,“F.Miulli”Regional General Hospital,Bari 70021,Italy [2]Unit of Anesthesia and Perioperative Medicine,“F.Miulli”Regional General Hospital,Bari 70021,Italy [3]Villa Pia Hospital,Rome 00151,Italy [4]Unit of Interventional Radiology,“F.Miulli”Regional General Hospital,Bari 70021,Italy

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2954-2961,共8页世界胃肠外科杂志（英文版）（电子版）

摘　　要：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.

关 键 词：Robotic surgery Awake surgery Liver resection Frail patient Locoregional anesthesia Conscious sedation Case report 

分 类 号：R657.3[医药卫生—外科学] TP242[医药卫生—临床医学]