Robotic surgery has been widely accepted in many kinds of
surgical procedures. Little is known about clinical effects of robotic-assisted
splenectomy and azygoportal disconnection (RSD) for gastroesophageal variceal
bleeding and secondary
hypersplenism owing to cirrhotic
portal hypertension. The aim of this study was to evaluate whether RSD is feasible and safe for patients with cirrhotic
portal hypertension and whether RSD is superior to laparoscopic
splenectomy and azygoportal disconnection (
LSD). We retrospectively investigated the clinical effects of 50 patients with
cirrhosis who underwent vagus nerve-preserving RSD (n = 20) and
LSD (n = 30) between September 2020 and October 2021. We compared patients' demographic, intraoperative, and perioperative variables. RSD and
LSD were successful in all patients.
Operative time did not differ significantly between the RSD group and
LSD group (151.15 ± 21.78 min vs. 144.50 ± 24.30 min, P > 0.05), but intraoperative blood loss were significantly reduced in the RSD group (61.00 ± 34.93 mL vs. 105.00 ± 68.77 mL, P < 0.05). No statistically significant differences were found regarding intraoperative allogeneic transfusion rate, visual analog scale
pain score on the postoperative first day, time to first oral intake, initial passage of
flatus, initial off-bed activity, postoperative
hospital stay, and overall perioperative complication rate (all P > 0.05). In conclusion, RSD is not only a technically feasible and safe procedure but it was associated with less blood loss than
LSD for cirrhotic
portal hypertension with gastroesophageal variceal
bleeding and secondary
hypersplenism. Registered at researchregistery.com: trial registration number is researchregistry7244, date of registration October 10, 2021, registered retrospectively.