An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy Journal Article
| Authors: | Chong, Y.; Prieto, M.; Gastaca, M.; Choi, S. H.; Sucandy, I.; Chiow, A. K. H.; Marino, M. V.; Wang, X.; Efanov, M.; Schotte, H.; D’Hondt, M.; Choi, G. H.; Krenzien, F.; Schmelzle, M.; Pratschke, J.; Kingham, T. P.; Giglio, M.; Troisi, R. I.; Lee, J. H.; Lai, E. C.; Tang, C. N.; Fuks, D.; D’Silva, M.; Han, H. S.; Kadam, P.; Sutcliffe, R. P.; Lee, K. F.; Chong, C. C.; Cheung, T. T.; Liu, Q.; Liu, R.; Goh, B. K. P.; Chan, C. Y.; De Meyere, C.; Salimgereeva, D.; Alikhanov, R.; Lee, L. S.; Jang, J. Y.; Montalti, R.; International, robotic; International robotic and laparoscopic liver resection study group investigators |
| Article Title: | An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy |
| Abstract: | Background: Left lateral sectionectomy (LLS) is one of the most commonly performed minimally invasive liver resections. While laparoscopic (L)-LLS is a well-established technique, over traditional open resection, it remains controversial if robotic (R)-LLS provides any advantages of L-LLS. Methods: A post hoc analysis of 997 patients from 21 international centres undergoing L-LLS or R-LLS from 2006 to 2020 was conducted. A total of 886 cases (214 R-LLS, 672 L-LLS) met study criteria. 1:1 and 1:2 propensity score matched (PSM) comparison was performed between R-LLS & L-LLS. Further subset analysis by Iwate difficulty was also performed. Outcomes measured include operating time, blood loss, open conversion, readmission rates, morbidity and mortality. Results: Comparison between R-LLS and L-LLS after PSM 1:2 demonstrated statistically significantly lower open conversion rate in R-LLS than L-LLS (0.6% versus 5%, p = 0.009) and median blood loss was also statistically significantly lower in R-LLS at 50 (80) versus 100 (170) in L-LLS (p = 0.011) after PSM 1:1 although there was no difference in the blood transfusion rate. Pringle manoeuvre was also found to be used more frequently in R-LLS, with 53(24.8%) cases versus to 84(12.5%) L-LLS cases (p < 0.001). There was no significant difference in the other key perioperative outcomes such as operating time, length of stay, postoperative morbidity, major morbidity and 90-day mortality between both groups. Conclusion: R-LLS was associated with similar key perioperative outcomes compared to L-LLS. It was also associated with significantly lower blood loss and open conversion rates compared to L-LLS. © 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. |
| Keywords: | adult; controlled study; treatment outcome; middle aged; retrospective studies; major clinical study; clinical feature; clinical trial; liver cirrhosis; liver neoplasms; laparoscopy; laparoscopic surgery; morbidity; cohort analysis; retrospective study; postoperative complication; postoperative complications; length of stay; multicenter study; liver tumor; operation duration; reoperation; intermethod comparison; minimally invasive surgery; hepatectomy; perioperative period; hospital readmission; robotic; enteropathy; laparoscopic; post hoc analysis; metastatic colorectal cancer; clinical outcome; procedures; mortality rate; propensity score; operative blood loss; humans; human; male; female; article; robotic surgical procedures; device failure; robot assisted surgery; left lateral sectionectomy; multiple tumor |
| Journal Title: | Surgical Endoscopy |
| Volume: | 37 |
| Issue: | 5 |
| ISSN: | 0930-2794 |
| Publisher: | Springer |
| Date Published: | 2023-05-01 |
| Start Page: | 3439 |
| End Page: | 3448 |
| Language: | English |
| DOI: | 10.1007/s00464-022-09790-x |
| PUBMED: | 36542135 |
| PROVIDER: | scopus |
| PMCID: | PMC10164043 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: Scopus |
