Robotic Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

The introduction of robotics in living donor liver transplantation has been revolutionary. We aimed to examine the safety of robotic living donor right hepatectomy (RLDRH) compared to open (ODRH) and laparoscopic (LADRH) approaches. A systematic review was carried out in Medline and six additional databases following PRISMA guidelines. Data on morbidity, postoperative liver function, and pain in donors and recipients were extracted from studies comparing RLDRH, ODRH, and LADRH published up to September 2020; PROSPERO (CRD42020214313). Dichotomous variables were pooled as risk ratios and continuous variables as weighted mean differences. Four studies with a total of 517 patients were included. In living donors, the postoperative total bilirubin level (MD: −0.7 95%CI −1.0, −0.4), length of hospital stay (MD: −0.8 95%CI −1.4, −0.3), Clavien–Dindo complications I–II (RR: 0.5 95%CI 0.2, 0.9), and pain score at day > 3 (MD: −0.6 95%CI −1.6, 0.4) were lower following RLDRH compared to ODRH. Furthermore, the pain score at day > 3 (MD: −0.4 95%CI −0.8, −0.09) was lower after RLDRH when compared to LADRH. In recipients, the postoperative AST level was lower (MD: −0.5 95%CI −0.9, −0.1) following RLDRH compared to ODRH. Moreover, the length of stay (MD: −6.4 95%CI −11.3, −1.5) was lower after RLDRH when compared to LADRH. In summary, we identified low- to unclear-quality evidence that RLDRH seems to be safe and feasible for adult living donor liver transplantation compared to the conventional approaches. No postoperative deaths were reported

Spatial distribution of major and trace elements in a mining dam: sources and relationships among elements of environmental concern

The concentration of major and trace elements have been determined in sediments samples taken from a mining dam, located in the upper area of the Tinto River basin (SW Spain). This dam, built to fulfil water needs for mining operations, is now completed clogged by accumulation of fine sediments. The results obtained for vertical and horizontal distribution of chemical elements showed highest average concentrations of Fe and Al, both with 10 %, and S (about 4 %). Toxic elements, such as As and Pb occur also with high concentrations (2515 and 5172 mg/kg, respectively). Determination of Enrichment Factors (EF) showed that sediments are enriched in elements related with the massive sulphide ore bodies and subsequent acid mine drainage processes. The elements Pb and As are that of major environmental concern, with enrichment factors higher than 10. Application of cluster analysis put in evidence the main sources of elements, allowing for the modelling of the origin of the accumulated matter. Therefore, in addition to contributions from sulphide (Fe, S) and gangue (Al, Mg), there are grouping of elements mobilized from phyllosilicates and feldspars, (e.g. Ca and K) as well as a specific group that reflects the geochemical affinity of rare earth elements in such acidic environment. Moreover, the way how elements are grouped testify the heterogeneity of geological contributions as well as the mining cycles over 4000 years of mining history in this worldwide known river basin.This study is a contribution of the DGCICYT-CGL2010-21268-C02-01 project, which has been financed by the Spanish Ministry of Education and Science, and the Andalusian Autonomous Government Excellence Projects, P10-RNM-6570 project. The Institute of Earth Sciences (ICT) is funding under contract with FCT (the Portuguese Science and Technology Foundation, Reference UID/GEO/04683/2013. The authors greatly appreciate the efforts of the three anonymous reviewers who carefully review the paper, and their valuable suggestions to improve the manuscript.info:eu-repo/semantics/publishedVersio