Robotic liver resection: A case-matched comparison Journal Article

Authors: Kingham, T. P.; Leung, U.; Kuk, D.; Gönen, M.; D’Angelica, M. I.; Allen, P. J.; DeMatteo, R. P.; Laudone, V. P.; Jarnagin, W. R.; Fong, Y.
Article Title: Robotic liver resection: A case-matched comparison
Abstract: Background: In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic hepatectomy, however, is still in its infancy. Our goals were to examine the adoption of robotic hepatectomy and to compare outcomes between open and robotic liver resections. Methods: The robotic hepatectomy experience of 64 patients was compared to a modern case-matched series of 64 open hepatectomy patients at the same center. Matching was according to benign/malignant diagnosis and number of segments resected. Patient data were obtained retrospectively. The main outcomes and measures were operative time, estimated blood loss, conversion rate (robotic to open), Pringle maneuver use, single non-anatomic wedge resection rate, resection margin size, complication rates (infectious, hepatic, pulmonary, cardiac), hospital stay length, ICU stay length, readmission rate, and 90-day mortality rate. Results: Sixty-four robotic hepatectomies were performed in 2010–2014. Forty-one percent were segmental and 34 % were wedge resections. There was a 6 % conversion rate, a 3 % 90-day mortality rate, and an 11 % morbidity rate. Compared to 64 matched patients who underwent open hepatectomy (2004–2012), there was a shorter median OR time (p = 0.02), lower median estimated blood loss (p < 0.001), and shorter median hospital stay (p < 0.001). Eleven of the robotic cases were isolated resections of tumors in segments 2, 7, and 8. Conclusions: Robotic hepatectomy is safe and effective. Increasing experience in more centers will allow definition of which hepatectomies can be performed robotically, and will enable optimization of outcomes and prospective examination of the economic cost of each approach. © 2016 Société Internationale de Chirurgie
Journal Title: World Journal of Surgery
Volume: 40
Issue: 6
ISSN: 0364-2313
Publisher: Springer  
Date Published: 2016-06-01
Start Page: 1422
End Page: 1428
Language: English
DOI: 10.1007/s00268-016-3446-9
PROVIDER: scopus
PMCID: PMC4870111
PUBMED: 26913732
Notes: Article in Press -- Export Date: 1 July 2016 -- Article in Press -- Source: Scopus
Citation Impact
MSK Authors
  1. Vincent Laudone
    75 Laudone
  2. Ronald P DeMatteo
    627 DeMatteo
  3. Mithat Gonen
    785 Gonen
  4. Peter Allen
    482 Allen
  5. William R Jarnagin
    654 Jarnagin
  6. Yuman Fong
    772 Fong
  7. T Peter Kingham
    343 Kingham
  8. Deborah Kuk
    86 Kuk
  9. Universe Yu Hang Leung
    12 Leung