Skip to main content
Erschienen in: Surgical Endoscopy 7/2021

02.07.2020

Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study

verfasst von: Chetana Lim, Claire Goumard, Chady Salloum, Antonella Tudisco, Niccolo Napoli, Ugo Boggi, Daniel Azoulay, Olivier Scatton

Erschienen in: Surgical Endoscopy | Ausgabe 7/2021

Einloggen, um Zugang zu erhalten

Abstract

Background

The recent development of 3D vision in laparoscopic and robotic surgical systems raises the question of whether these two procedures are equivalent. The aim of this study was to evaluate the surgical and long-term oncological outcomes of 3D laparoscopic (3D-LLR) and robotic liver resection (RLR) for hepatocellular carcinoma (HCC).

Methods

The data for operative time, morbidity, margins, and survival were reviewed for 3D-LLR and compared with RLR.

Results

From 2011 to 2017, 93 patients with HCC, including 58 (62%) with cirrhosis, underwent 3D-LLR [49 (53%)] or RLR [44 (47%)]. No difference was observed in operative time (269 vs. 252 min; p = 0.52), overall (27% vs. RLR: 16%; p = 0.49) and severe morbidity (4% vs. 2%; p = 0.77) or in the surgical margin width (9 vs. 11 mm; p = 0.30) between the 3D-LLR and RLR groups. The 3-year overall and recurrence-free survival rates after 3D-LLR and RLR were 82% and 24% and 91% (p = 0.16) and 48% (p = 0.18), respectively.

Conclusions

The 3D-LLR and RLR systems provide comparable surgical margins with similar short- and long-term oncological outcomes.
Literatur
1.
Zurück zum Zitat EASL Clinical Practice Guidelines (2018) Management of hepatocellular carcinoma. J Hepatol 69(1):182–236CrossRef EASL Clinical Practice Guidelines (2018) Management of hepatocellular carcinoma. J Hepatol 69(1):182–236CrossRef
2.
Zurück zum Zitat Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schön MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J (2015) Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261(4):619–629PubMed Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schön MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J (2015) Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261(4):619–629PubMed
3.
Zurück zum Zitat Buell JF, Cherqui D, Geller DA, O'Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D'Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg 250(5):825–830CrossRef Buell JF, Cherqui D, Geller DA, O'Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D'Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg 250(5):825–830CrossRef
4.
Zurück zum Zitat Liu R, Wakabayashi G, Kim HJ, Choi GH, Yiengpruksawan A, Fong Y, He J, Boggi U, Troisi RI, Efanov M, Azoulay D, Panaro F, Pessaux P, Wang XY, Zhu JY, Zhang SG, Sun CD, Wu Z, Tao KS, Yang KH, Fan J, Chen XP (2019) International consensus statement on robotic hepatectomy surgery in 2018. World J Gastroenterol 25(12):1432–1444CrossRef Liu R, Wakabayashi G, Kim HJ, Choi GH, Yiengpruksawan A, Fong Y, He J, Boggi U, Troisi RI, Efanov M, Azoulay D, Panaro F, Pessaux P, Wang XY, Zhu JY, Zhang SG, Sun CD, Wu Z, Tao KS, Yang KH, Fan J, Chen XP (2019) International consensus statement on robotic hepatectomy surgery in 2018. World J Gastroenterol 25(12):1432–1444CrossRef
5.
Zurück zum Zitat Kawai T, Goumard C, Jeune F, Savier E, Vaillant JC, Scatton O (2018) Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis. Surg Endosc 32(7):3273–3281CrossRef Kawai T, Goumard C, Jeune F, Savier E, Vaillant JC, Scatton O (2018) Laparoscopic liver resection for colorectal liver metastasis patients allows patients to start adjuvant chemotherapy without delay: a propensity score analysis. Surg Endosc 32(7):3273–3281CrossRef
6.
Zurück zum Zitat Kawai T, Goumard C, Jeune F, Komatsu S, Soubrane O, Scatton O (2018) 3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy. Surg Endosc 32(8):3706–3712CrossRef Kawai T, Goumard C, Jeune F, Komatsu S, Soubrane O, Scatton O (2018) 3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy. Surg Endosc 32(8):3706–3712CrossRef
7.
Zurück zum Zitat Lim C, Salloum C, Tudisco A, Ricci C, Osseis M, Napoli N, Lahat E, Boggi U, Azoulay D (2019) Short- and long-term outcomes after robotic and laparoscopic liver resection for malignancies: a propensity score-matched study. World J Surg 43(6):1594–1603CrossRef Lim C, Salloum C, Tudisco A, Ricci C, Osseis M, Napoli N, Lahat E, Boggi U, Azoulay D (2019) Short- and long-term outcomes after robotic and laparoscopic liver resection for malignancies: a propensity score-matched study. World J Surg 43(6):1594–1603CrossRef
8.
Zurück zum Zitat Salloum C, Lim C, Lahat E, Gavara CG, Levesque E, Compagnon P, Azoulay D (2016) Robotic-assisted versus laparoscopic left lateral sectionectomy: analysis of surgical outcomes and costs by a Propensity Score Matched Cohort Study. World J Surg 41(2):516–524CrossRef Salloum C, Lim C, Lahat E, Gavara CG, Levesque E, Compagnon P, Azoulay D (2016) Robotic-assisted versus laparoscopic left lateral sectionectomy: analysis of surgical outcomes and costs by a Propensity Score Matched Cohort Study. World J Surg 41(2):516–524CrossRef
9.
Zurück zum Zitat Salloum C, Subar D, Memeo R, Tayar C, Laurent A, Malek A, Azoulay D (2014) Laparoscopic robotic liver surgery: the Henri Mondor initial experience of 20 cases. J Robot Surg 8(2):119–124CrossRef Salloum C, Subar D, Memeo R, Tayar C, Laurent A, Malek A, Azoulay D (2014) Laparoscopic robotic liver surgery: the Henri Mondor initial experience of 20 cases. J Robot Surg 8(2):119–124CrossRef
12.
Zurück zum Zitat Spampinato MG, Coratti A, Bianco L, Caniglia F, Laurenzi A, Puleo F, Ettorre GM, Boggi U (2014) Perioperative outcomes of laparoscopic and robot-assisted major hepatectomies: an Italian multi-institutional comparative study. Surg Endosc 28(10):2973–2979CrossRef Spampinato MG, Coratti A, Bianco L, Caniglia F, Laurenzi A, Puleo F, Ettorre GM, Boggi U (2014) Perioperative outcomes of laparoscopic and robot-assisted major hepatectomies: an Italian multi-institutional comparative study. Surg Endosc 28(10):2973–2979CrossRef
13.
Zurück zum Zitat Boggi U, Caniglia F, Vistoli F, Costa F, Pieroni E, Perrone VG (2015) Laparoscopic robot-assisted resection of tumors located in posterosuperior liver segments. Updates Surg 67(2):177–183CrossRef Boggi U, Caniglia F, Vistoli F, Costa F, Pieroni E, Perrone VG (2015) Laparoscopic robot-assisted resection of tumors located in posterosuperior liver segments. Updates Surg 67(2):177–183CrossRef
14.
Zurück zum Zitat Boggi U, Caniglia F, Amorese G (2013) Laparoscopic robot-assisted major hepatectomy. J Hepatobiliary Pancreat Sci 21(1):3–10CrossRef Boggi U, Caniglia F, Amorese G (2013) Laparoscopic robot-assisted major hepatectomy. J Hepatobiliary Pancreat Sci 21(1):3–10CrossRef
15.
Zurück zum Zitat Bismuth H (1982) Surgical anatomy and anatomical surgery of the liver. World J Surg 6(1):3–9CrossRef Bismuth H (1982) Surgical anatomy and anatomical surgery of the liver. World J Surg 6(1):3–9CrossRef
16.
Zurück zum Zitat Lim C, Salloum C, Lahat E, Sotirov D, Eshkenazy R, Shwaartz C, Azoulay D (2019) Impact of narrow margin and R1 resection for hepatocellular carcinoma on the salvage liver transplantation strategy. An intention-to-treat analysis. HPB, OxfordCrossRef Lim C, Salloum C, Lahat E, Sotirov D, Eshkenazy R, Shwaartz C, Azoulay D (2019) Impact of narrow margin and R1 resection for hepatocellular carcinoma on the salvage liver transplantation strategy. An intention-to-treat analysis. HPB, OxfordCrossRef
17.
Zurück zum Zitat Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Büchler MW, Weitz J (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149(5):680–688CrossRef Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, Fan ST, Yokoyama Y, Crawford M, Makuuchi M, Christophi C, Banting S, Brooke-Smith M, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Nimura Y, Figueras J, DeMatteo RP, Büchler MW, Weitz J (2011) Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery 149(5):680–688CrossRef
18.
Zurück zum Zitat Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, Koch M, Makuuchi M, Dematteo RP, Christophi C, Banting S, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Yokoyama Y, Fan ST, Nimura Y, Figueras J, Capussotti L, Büchler MW, Weitz J (2011) Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 149(5):713–724CrossRef Rahbari NN, Garden OJ, Padbury R, Brooke-Smith M, Crawford M, Adam R, Koch M, Makuuchi M, Dematteo RP, Christophi C, Banting S, Usatoff V, Nagino M, Maddern G, Hugh TJ, Vauthey JN, Greig P, Rees M, Yokoyama Y, Fan ST, Nimura Y, Figueras J, Capussotti L, Büchler MW, Weitz J (2011) Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 149(5):713–724CrossRef
19.
Zurück zum Zitat Rahbari NN, Garden OJ, Padbury R, Maddern G, Koch M, Hugh TJ, Fan ST, Nimura Y, Figueras J, Vauthey JN, Rees M, Adam R, Dematteo RP, Greig P, Usatoff V, Banting S, Nagino M, Capussotti L, Yokoyama Y, Brooke-Smith M, Crawford M, Christophi C, Makuuchi M, Büchler MW, Weitz J (2011) Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB (Oxford) 13(8):528–535CrossRef Rahbari NN, Garden OJ, Padbury R, Maddern G, Koch M, Hugh TJ, Fan ST, Nimura Y, Figueras J, Vauthey JN, Rees M, Adam R, Dematteo RP, Greig P, Usatoff V, Banting S, Nagino M, Capussotti L, Yokoyama Y, Brooke-Smith M, Crawford M, Christophi C, Makuuchi M, Büchler MW, Weitz J (2011) Post-hepatectomy haemorrhage: a definition and grading by the International Study Group of Liver Surgery (ISGLS). HPB (Oxford) 13(8):528–535CrossRef
20.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef
21.
Zurück zum Zitat Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA (2013) The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg 258(1):1–7CrossRef Slankamenac K, Graf R, Barkun J, Puhan MA, Clavien PA (2013) The comprehensive complication index: a novel continuous scale to measure surgical morbidity. Ann Surg 258(1):1–7CrossRef
22.
Zurück zum Zitat Benchimol EI, Langan S, Guttmann A (2012) Call to RECORD: the need for complete reporting of research using routinely collected health data. J Clin Epidemiol 66(7):703–705CrossRef Benchimol EI, Langan S, Guttmann A (2012) Call to RECORD: the need for complete reporting of research using routinely collected health data. J Clin Epidemiol 66(7):703–705CrossRef
23.
Zurück zum Zitat Famularo S, Giani A, Di Sandro S, Sandini M, Giacomoni A, Pinotti E, Lauterio A, Gianotti L, De Carlis L, Romano F (2017) Does the Pringle maneuver affect survival and recurrence following surgical resection for hepatocellular carcinoma? A western series of 441 patients. J Surg Oncol 117(2):198–206CrossRef Famularo S, Giani A, Di Sandro S, Sandini M, Giacomoni A, Pinotti E, Lauterio A, Gianotti L, De Carlis L, Romano F (2017) Does the Pringle maneuver affect survival and recurrence following surgical resection for hepatocellular carcinoma? A western series of 441 patients. J Surg Oncol 117(2):198–206CrossRef
24.
Zurück zum Zitat Xu W, Xu H, Yang H, Liao W, Ge P, Ren J, Sang X, Lu X, Zhong S, Mao Y (2016) Continuous Pringle maneuver does not affect outcomes of patients with hepatocellular carcinoma after curative resection. Asia Pac J Clin Oncol 13(5):e321–e330CrossRef Xu W, Xu H, Yang H, Liao W, Ge P, Ren J, Sang X, Lu X, Zhong S, Mao Y (2016) Continuous Pringle maneuver does not affect outcomes of patients with hepatocellular carcinoma after curative resection. Asia Pac J Clin Oncol 13(5):e321–e330CrossRef
25.
Zurück zum Zitat Liu S, Li X, Li H, Guo L, Zhang B, Gong Z, Zhang J, Ye Q (2016) Longer duration of the Pringle maneuver is associated with hepatocellular carcinoma recurrence following curative resection. J Surg Oncol 114(1):112–118CrossRef Liu S, Li X, Li H, Guo L, Zhang B, Gong Z, Zhang J, Ye Q (2016) Longer duration of the Pringle maneuver is associated with hepatocellular carcinoma recurrence following curative resection. J Surg Oncol 114(1):112–118CrossRef
26.
Zurück zum Zitat Yamashita YI, Hayashi H, Imai K, Okabe H, Nakagawa S, Kitamura F, Uemura N, Nakao Y, Yusa T, Itoyama R, Yamao T, Umesaki N, Miyata T, Chikamoto A, Shimokawa M, Baba H (2019) Perioperative allogeneic blood transfusion does not influence patient survival after hepatectomy for hepatocellular carcinoma: a propensity score matching analysis. World J Surg 43(11):2894–2901CrossRef Yamashita YI, Hayashi H, Imai K, Okabe H, Nakagawa S, Kitamura F, Uemura N, Nakao Y, Yusa T, Itoyama R, Yamao T, Umesaki N, Miyata T, Chikamoto A, Shimokawa M, Baba H (2019) Perioperative allogeneic blood transfusion does not influence patient survival after hepatectomy for hepatocellular carcinoma: a propensity score matching analysis. World J Surg 43(11):2894–2901CrossRef
27.
Zurück zum Zitat Peng T, Zhao G, Wang L, Wu J, Cui H, Liang Y, Zhou R, Liu Z, Wang Q (2017) No impact of perioperative blood transfusion on prognosis after curative resection for hepatocellular carcinoma: a propensity score matching analysis. Clin Transl Oncol 20(6):719–728CrossRef Peng T, Zhao G, Wang L, Wu J, Cui H, Liang Y, Zhou R, Liu Z, Wang Q (2017) No impact of perioperative blood transfusion on prognosis after curative resection for hepatocellular carcinoma: a propensity score matching analysis. Clin Transl Oncol 20(6):719–728CrossRef
28.
Zurück zum Zitat Yang T, Lu JH, Lau WY, Zhang TY, Zhang H, Shen YN, Alshebeeb K, Wu MC, Schwartz M, Shen F (2015) Perioperative blood transfusion does not influence recurrence-free and overall survivals after curative resection for hepatocellular carcinoma: a propensity score matching analysis. J Hepatol 64(3):583–593CrossRef Yang T, Lu JH, Lau WY, Zhang TY, Zhang H, Shen YN, Alshebeeb K, Wu MC, Schwartz M, Shen F (2015) Perioperative blood transfusion does not influence recurrence-free and overall survivals after curative resection for hepatocellular carcinoma: a propensity score matching analysis. J Hepatol 64(3):583–593CrossRef
29.
Zurück zum Zitat Fiorentini G, Swaid F, Cipriani F, Ratti F, Heres C, Tsung A, Aldrighetti L, Geller DA (2019) Propensity score-matched analysis of pure laparoscopic versus hand-assisted/hybrid major hepatectomy at two western centers. World J Surg 43(8):2025–2037CrossRef Fiorentini G, Swaid F, Cipriani F, Ratti F, Heres C, Tsung A, Aldrighetti L, Geller DA (2019) Propensity score-matched analysis of pure laparoscopic versus hand-assisted/hybrid major hepatectomy at two western centers. World J Surg 43(8):2025–2037CrossRef
30.
Zurück zum Zitat Cho JY, Han HS, Yoon YS, Shin SH (2008) Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location. Surgery 144(1):32–38CrossRef Cho JY, Han HS, Yoon YS, Shin SH (2008) Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location. Surgery 144(1):32–38CrossRef
31.
Zurück zum Zitat Patriti A, Cipriani F, Ratti F, Bartoli A, Ceccarelli G, Casciola L, Aldrighetti L (2014) Robot-assisted versus open liver resection in the right posterior section. JSLS 18(3):e2014CrossRef Patriti A, Cipriani F, Ratti F, Bartoli A, Ceccarelli G, Casciola L, Aldrighetti L (2014) Robot-assisted versus open liver resection in the right posterior section. JSLS 18(3):e2014CrossRef
32.
Zurück zum Zitat Aghayan DL, Fretland ÅA, Kazaryan AM, Sahakyan MA, Dagenborg VJ, Bjørnbeth BA, Flatmark K, Kristiansen R, Edwin B (2019) Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial. HPB, Oxford Aghayan DL, Fretland ÅA, Kazaryan AM, Sahakyan MA, Dagenborg VJ, Bjørnbeth BA, Flatmark K, Kristiansen R, Edwin B (2019) Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial. HPB, Oxford
33.
Zurück zum Zitat Montalti R, Scuderi V, Patriti A, Vivarelli M, Troisi RI (2015) Robotic versus laparoscopic resections of posterosuperior segments of the liver: a propensity score-matched comparison. Surg Endosc 30(3):1004–1013CrossRef Montalti R, Scuderi V, Patriti A, Vivarelli M, Troisi RI (2015) Robotic versus laparoscopic resections of posterosuperior segments of the liver: a propensity score-matched comparison. Surg Endosc 30(3):1004–1013CrossRef
34.
Zurück zum Zitat Ramanathan R, Salamanca JI, Mandhani A, Leung RA, Rao SR, Berryhill R, Tewari A (2009) Does 3-dimensional (3-D) visualization improve the quality of assistance during robotic radical prostatectomy? World J Urol 27(1):95–99CrossRef Ramanathan R, Salamanca JI, Mandhani A, Leung RA, Rao SR, Berryhill R, Tewari A (2009) Does 3-dimensional (3-D) visualization improve the quality of assistance during robotic radical prostatectomy? World J Urol 27(1):95–99CrossRef
Metadaten
Titel
Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study
verfasst von
Chetana Lim
Claire Goumard
Chady Salloum
Antonella Tudisco
Niccolo Napoli
Ugo Boggi
Daniel Azoulay
Olivier Scatton
Publikationsdatum
02.07.2020
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 7/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07762-7

Weitere Artikel der Ausgabe 7/2021

Surgical Endoscopy 7/2021 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.