TY - JOUR
T1 - Propensity score-matched analysis comparing robotic versus laparoscopic minor liver resections of the anterolateral segments
T2 - an international multi-center study of 10,517 cases
AU - Hu, Jie
AU - Guo, Yuxin
AU - Wang, Xiaoying
AU - Yeow, Marcus
AU - Wu, Andrew G. R.
AU - Fuks, David
AU - Soubrane, Olivier
AU - Dokmak, Safi
AU - Gruttadauria, Salvatore
AU - Zimmitti, Giuseppe
AU - Ratti, Francesca
AU - Kato, Yutaro
AU - Scatton, Olivier
AU - Herman, Paulo
AU - Aghayan, Davit L.
AU - Marino, Marco V.
AU - Croner, Roland S.
AU - Mazzaferro, Vincenzo
AU - Chiow, Adrian K. H.
AU - Sucandy, Iswanto
AU - Ivanecz, Arpad
AU - Choi, Sung Hoon
AU - Lee, Jae Hoon
AU - Gastaca, Mikel
AU - Vivarelli, Marco
AU - Giuliante, Felice
AU - Ruzzenente, Andrea
AU - Yong, Chee-Chien
AU - Yin, Mengqiu
AU - Fondevila, Constantino
AU - Efanov, Mikhail
AU - Morise, Zenichi
AU - di Benedetto, Fabrizio
AU - Brustia, Raffaele
AU - Valle, Raffaele Dalla
AU - Boggi, Ugo
AU - Geller, David
AU - Belli, Andrea
AU - Memeo, Riccardo
AU - Mejia, Alejandro
AU - Park, James O.
AU - Rotellar, Fernando
AU - Choi, Gi-Hong
AU - Robles-Campos, Ricardo
AU - Hasegawa, Kiyoshi
AU - Swijnenburg, Rutger-Jan
AU - Sutcliffe, Robert P.
AU - Pratschke, Johann
AU - Lai, Eric C. H.
AU - Chong, Charing C. N.
AU - D’Hondt, Mathieu
AU - Monden, Kazuteru
AU - Lopez-Ben, Santiago
AU - Kingham, T. Peter
AU - Schmelzle, Moritz
AU - Hawksworth, Jason
AU - Peng, Yufu
AU - Ferrero, Alessandro
AU - Ettorre, Giuseppe Maria
AU - Cherqui, Daniel
AU - Liang, Xiao
AU - Wakabayashi, Go
AU - Troisi, Roberto I.
AU - Cillo, Umberto
AU - Cheung, Tan-To
AU - Sugimoto, Motokazu
AU - Sugioka, Atsushi
AU - Han, Ho-Seong
AU - Long, Tran Cong duy
AU - Hilal, Mohammad Abu
AU - Zhang, Wanguang
AU - Wei, Yonggang
AU - Chen, Kuo-Hsin
AU - Aldrighetti, Luca
AU - Edwin, Bjorn
AU - International Robotic and Laparoscopic Liver Resection Study Group Investigators
AU - Liu, Rong
AU - Goh, Brian K. P.
N1 - Publisher Copyright:
© 2024 Wolters Kluwer Health. All rights reserved.
PY - 2024
Y1 - 2024
N2 - Objective: To compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments. Background: Robotic liver surgery has been gaining prominence over the years with increasing usage for a myriad of hepatic resections. Robotic liver resections(RLR) has demonstrated non-inferiority to laparoscopic(L)LR while illustrating advantages over conventional laparoscopy especially for technically difficult and major LR. However, the advantage of RMLR for the anterolateral(AL) (segments II, III, IVb, V and VI) segments, has not been clearly demonstrated. Methods: Between 2008 to 2022, 15,356 of 29,861 patients from 68 international centres underwent robotic(R) or laparoscopic minor liver resections (LMLR) for the AL segments Propensity score matching (PSM) analysis was performed for matched analysis. Results: 10,517 patients met the study criteria of which 1,481 underwent RMLR and 9,036 underwent LMLR. A PSM cohort of 1,401 patients in each group were identified for analysis. Compared to the LMLR cohort, the RMLR cohort demonstrated significantly lower median blood loss (75ml vs. 100ml, p<0.001), decreased blood transfusion (3.1% vs. 5.4%, p=0.003), lower incidence of major morbidity (2.5% vs. 4.6%, p=0.004), lower proportion of open conversion (1.2% vs. 4.5%, p<0.001), shorter post operative stay (4 days vs. 5 days, p<0.001), but higher rate of 30-day readmission (3.5% vs. 2.1%, p=0.042). These results were then validated by a 1:2 PSM analysis. In the subset analysis for 3,614 patients with cirrhosis, RMLR showed lower median blood loss, decreased blood transfusion, lower open conversion and shorter post operative stay than LMLR. Conclusion: RMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.
AB - Objective: To compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments. Background: Robotic liver surgery has been gaining prominence over the years with increasing usage for a myriad of hepatic resections. Robotic liver resections(RLR) has demonstrated non-inferiority to laparoscopic(L)LR while illustrating advantages over conventional laparoscopy especially for technically difficult and major LR. However, the advantage of RMLR for the anterolateral(AL) (segments II, III, IVb, V and VI) segments, has not been clearly demonstrated. Methods: Between 2008 to 2022, 15,356 of 29,861 patients from 68 international centres underwent robotic(R) or laparoscopic minor liver resections (LMLR) for the AL segments Propensity score matching (PSM) analysis was performed for matched analysis. Results: 10,517 patients met the study criteria of which 1,481 underwent RMLR and 9,036 underwent LMLR. A PSM cohort of 1,401 patients in each group were identified for analysis. Compared to the LMLR cohort, the RMLR cohort demonstrated significantly lower median blood loss (75ml vs. 100ml, p<0.001), decreased blood transfusion (3.1% vs. 5.4%, p=0.003), lower incidence of major morbidity (2.5% vs. 4.6%, p=0.004), lower proportion of open conversion (1.2% vs. 4.5%, p<0.001), shorter post operative stay (4 days vs. 5 days, p<0.001), but higher rate of 30-day readmission (3.5% vs. 2.1%, p=0.042). These results were then validated by a 1:2 PSM analysis. In the subset analysis for 3,614 patients with cirrhosis, RMLR showed lower median blood loss, decreased blood transfusion, lower open conversion and shorter post operative stay than LMLR. Conclusion: RMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.
KW - Propensity score-matching
KW - cirrhosis
KW - laparoscopic liver resections
KW - minor liver resection, anterolateral segments
KW - robotic liver resections
UR - https://www.scopus.com/pages/publications/85203458623
U2 - 10.1097/SLA.0000000000006523
DO - 10.1097/SLA.0000000000006523
M3 - Article
C2 - 39234677
SN - 0003-4932
JO - Annals of surgery
JF - Annals of surgery
ER -