| Authors: |
Liu, Q.; Zhang, W.; Zhao, J. J.; Syn, N. L.; Cipriani, F.; Alzoubi, M.; Aghayan, D. L.; Siow, T. F.; Lim, C.; Scatton, O.; Herman, P.; Coelho, F. F.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Prieto, M.; Vivarelli, M.; Giuliante, F.; Dalla Valle, B.; Ruzzenente, A.; Yong, C. C.; Chen, Z.; Yin, M.; Fondevila, C.; Efanov, M.; Morise, Z.; Di Benedetto, F.; Brustia, R.; Dalla Valle, R.; Boggi, U.; Geller, D.; Belli, A.; Memeo, R.; Gruttadauria, S.; Mejia, A.; Park, J. O.; Rotellar, F.; Choi, G. H.; Robles-Campos, R.; Wang, X.; Sutcliffe, R. P.; Schmelzle, M.; Pratschke, J.; Tang, C. N.; Chong, C. C. N.; Lee, K. F.; Meurs, J.; D'Hondt, M.; Monden, K.; Lopez-Ben, S.; Kingham, T. P.; Ferrero, A.; Ettorre, G. M.; Levi Sandri, G. B.; Saleh, M.; Cherqui, D.; Zheng, J.; Liang, X.; Mazzotta, A.; Soubrane, O.; Wakabayashi, G.; Troisi, R. I.; Cheung, T. T.; Kato, Y.; Sugioka, A.; D'Silva, M.; Han, H. S.; Nghia, P. P.; Long, T. C. D.; Edwin, B.; Fuks, D.; Chen, K. H.; Abu Hilal, M.; Aldrighetti, L.; Liu, R.; Goh, B. K. P.; and International robotic and laparoscopic liver resection study group investigators |
| Article Title: |
Propensity-score matched and coarsened-exact matched analysis comparing robotic and laparoscopic major hepatectomies: An international multicenter study of 4822 cases |
| Abstract: |
Objective: To compare the outcomes between robotic major hepatectomy (R-MH) and laparoscopic major hepatectomy (L-MH). Background: Robotic techniques may overcome the limitations of laparoscopic liver resection. However, it is unknown whether R-MH is superior to L-MH. Methods: This is a post hoc analysis of a multicenter database of patients undergoing R-MH or L-MH at 59 international centers from 2008 to 2021. Data on patient demographics, center experience volume, perioperative outcomes, and tumor characteristics were collected and analyzed. Both 1:1 propensity-score matched (PSM) and coarsened-exact matched (CEM) analyses were performed to minimize selection bias between both groups Results: A total of 4822 cases met the study criteria, of which 892 underwent R-MH and 3930 underwent L-MH. Both 1:1 PSM (841 R-MH vs. 841 L-MH) and CEM (237 R-MH vs. 356 L-MH) were performed. R-MH was associated with significantly less blood loss {PSM:200.0 [interquartile range (IQR):100.0, 450.0] vs 300.0 (IQR:150.0, 500.0) mL; P = 0.012; CEM:170.0 (IQR: 90.0, 400.0) vs 200.0 (IQR:100.0, 400.0) mL; P = 0.006}, lower rates of Pringle maneuver application (PSM: 47.1% vs 63.0%; P < 0.001; CEM: 54.0% vs 65.0%; P = 0.007) and open conversion (PSM: 5.1% vs 11.9%; P < 0.001; CEM: 5.5% vs 10.4%, P = 0.04) compared with L-MH. On subset analysis of 1273 patients with cirrhosis, R-MH was associated with a lower postoperative morbidity rate (PSM: 19.5% vs 29.9%; P = 0.02; CEM 10.4% vs 25.5%; P = 0.02) and shorter postoperative stay [PSM: 6.9 (IQR: 5.0, 9.0) days vs 8.0 (IQR: 6.0 11.3) days; P < 0.001; CEM 7.0 (IQR: 5.0, 9.0) days vs 7.0 (IQR: 6.0, 10.0) days; P = 0.047]. Conclusions: This international multicenter study demonstrated that R-MH was comparable to L-MH in safety and was associated with reduced blood loss, lower rates of Pringle maneuver application, and conversion to open surgery. © 2023 Lippincott Williams and Wilkins. All rights reserved. |
| Keywords: |
adult; controlled study; retrospective studies; major clinical study; clinical trial; mortality; liver cell carcinoma; liver cirrhosis; carcinoma, hepatocellular; liver neoplasms; outcome assessment; lymph node dissection; laparoscopy; morbidity; retrospective study; postoperative complication; postoperative complications; length of stay; multicenter study; liver tumor; operation duration; reoperation; intermethod comparison; liver surgery; hepatectomy; liver cancer; hospital readmission; laparoscopic liver resection; post hoc analysis; comparative effectiveness; demographics; multicenter study (topic); procedures; major hepatectomy; propensity score; conversion to open surgery; operative blood loss; humans; human; male; female; article; right hepatectomy; robotic surgical procedures; robot assisted surgery; robotic liver resection; multiple tumor; extended right hepatectomy
|
| Journal Title: |
Annals of Surgery
|
| Volume: |
278 |
| Issue: |
6 |
| ISSN: |
0003-4932 |
| Publisher: |
Lippincott Williams & Wilkins
|
| Date Published: |
2023-12-01 |
| Start Page: |
969 |
| End Page: |
975 |
| Language: |
English |
| DOI: |
10.1097/sla.0000000000005855
|
| PUBMED: |
37058429
|
| PROVIDER: |
scopus
|
| DOI/URL: |
|
| Notes: |
Article -- Source: Scopus |
