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Background <p>Hepatic caudate lobe hemangiomas present unique surgical challenges due to the segment’s deep location amidst critical vasculature (IVC, portal vein, hepatic veins). The literature on hepatic caudate lobe hemangiomas remains limited, resulting in a lack of comprehensive understanding and standardized treatment protocols for this condition. By comparing the surgical and perioperative outcomes of robotic versus open complete isolated caudate lobectomy for hemangiomas, this study aims to advance our understanding and management of this disease.</p> Methods <p>This single-center study included 83 patients who underwent complete isolated caudate lobe hemangioma resection. Patients were allocated to two groups: the robotic liver resection group (RLR, n = 33) and the open liver resection group (OLR, n = 50). Demographic characteristics and perioperative outcomes were compared between the two cohorts. Additionally, we explored the risk factors for intraoperative bleeding and conducted a subgroup analysis of patients with BMI ≥ 25&#xa0;kg/m<sup>2</sup>.</p> Results <p>RLR demonstrated superior outcomes vs OLR: shorter median operative time (median 105.0 vs. 192.5&#xa0;min, <i>p</i> &lt; 0.001), reduced blood loss (50 vs 300&#xa0;mL; <i>p</i>  &lt; 0.001), lower transfusion rates (3.0% vs 20.0%; <i>p</i> &lt; 0.05), abbreviated hospital stay (9 vs 16&#xa0;days; <i>p</i> &lt; 0.001), and faster recovery (postoperative stay: 5 vs 8&#xa0;days; <i>p</i>  &lt; 0.001). Univariate analysis revealed that increased blood loss was significantly associated with surgical approach, platelet count, POD (postoperative days), operation time, and ALT level. Multivariate analysis confirmed that longer operation time was an independent predictor of increased intraoperative blood loss. High-BMI RLR patients had significantly reduced operative time (105.0 vs 231.0&#xa0;min; <i>p</i> = 0.001), blood loss (30.0 vs 400.0&#xa0;mL; <i>p</i> &lt; 0.001).</p> Conclusion <p>Robotic isolated caudate lobectomy for hemangioma is feasible and safe, offering significant perioperative advantages over open surgery—including reduced blood loss, shorter hospitalization, and accelerated recovery—even in high-BMI patients. Robotic resection represents a viable surgical option for selected patients with hepatic caudate lobe hemangiomas.</p>

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Comparison of perioperative outcomes between robotic-assisted and open resection for hepatic caudate lobe hemangioma: a single-center retrospective study

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Jiarui Chen,
  • Aixian Zhang,
  • Lizhao Yu,
  • Bo Yang,
  • Yanpeng Li,
  • Kedi Zhang,
  • Yanzhe Liu,
  • Minggen Hu

摘要

Background

Hepatic caudate lobe hemangiomas present unique surgical challenges due to the segment’s deep location amidst critical vasculature (IVC, portal vein, hepatic veins). The literature on hepatic caudate lobe hemangiomas remains limited, resulting in a lack of comprehensive understanding and standardized treatment protocols for this condition. By comparing the surgical and perioperative outcomes of robotic versus open complete isolated caudate lobectomy for hemangiomas, this study aims to advance our understanding and management of this disease.

Methods

This single-center study included 83 patients who underwent complete isolated caudate lobe hemangioma resection. Patients were allocated to two groups: the robotic liver resection group (RLR, n = 33) and the open liver resection group (OLR, n = 50). Demographic characteristics and perioperative outcomes were compared between the two cohorts. Additionally, we explored the risk factors for intraoperative bleeding and conducted a subgroup analysis of patients with BMI ≥ 25 kg/m2.

Results

RLR demonstrated superior outcomes vs OLR: shorter median operative time (median 105.0 vs. 192.5 min, p < 0.001), reduced blood loss (50 vs 300 mL; p  < 0.001), lower transfusion rates (3.0% vs 20.0%; p < 0.05), abbreviated hospital stay (9 vs 16 days; p < 0.001), and faster recovery (postoperative stay: 5 vs 8 days; p  < 0.001). Univariate analysis revealed that increased blood loss was significantly associated with surgical approach, platelet count, POD (postoperative days), operation time, and ALT level. Multivariate analysis confirmed that longer operation time was an independent predictor of increased intraoperative blood loss. High-BMI RLR patients had significantly reduced operative time (105.0 vs 231.0 min; p = 0.001), blood loss (30.0 vs 400.0 mL; p < 0.001).

Conclusion

Robotic isolated caudate lobectomy for hemangioma is feasible and safe, offering significant perioperative advantages over open surgery—including reduced blood loss, shorter hospitalization, and accelerated recovery—even in high-BMI patients. Robotic resection represents a viable surgical option for selected patients with hepatic caudate lobe hemangiomas.