Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases.
Cheung, Tan-To Liu, Rong Cipriani, Federica Wang, Xiaoying Efanov, Mikhail Fuks, David Choi, Gi-Hong Syn, Nicholas L Chong, Charing C N Di Benedetto, Fabrizio
Cheung, Tan-To
Liu, Rong
Cipriani, Federica
Wang, Xiaoying
Efanov, Mikhail
Fuks, David
Choi, Gi-Hong
Syn, Nicholas L
Chong, Charing C N
Di Benedetto, Fabrizio
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2023-03-17
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Abstract
Background: The use of laparoscopic (LLR) and robotic liver resections (RLR) has been safely performed in many institutions for liver tumours. A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours ≥10 cm.
Methods: This was a retrospective review of 971 patients who underwent LLR and RLR for huge (≥10 cm) tumors at 42 international centers between 2002-2020.
Results: One hundred RLR and 699 LLR which met study criteria were included. The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching (PSM) (73 vs. 219). Before PSM, LLR was associated with significantly increased frequency of previous abdominal surgery, malignant pathology, liver cirrhosis and increased median blood. After PSM, RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time (242 vs. 290 min, P=0.286), transfusion rate rate (19.2% vs. 16.9%, P=0.652), median blood loss (200 vs. 300 mL, P=0.694), open conversion rate (8.2% vs. 11.0%, P=0.519), morbidity (28.8% vs. 21.9%, P=0.221), major morbidity (4.1% vs. 9.6%, P=0.152), mortality and postoperative length of stay (6 vs. 6 days, P=0.435).
Conclusions: RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes. There was no significant difference in perioperative outcomes after RLR or LLR.
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Cheung TT, Liu R, Cipriani F, Wang X, Efanov M, Fuks D, Choi GH, Syn NL, Chong CCN, Di Benedetto F, Robles-Campos R, Mazzaferro V, Rotellar F, Lopez-Ben S, Park JO, Mejia A, Sucandy I, Chiow AKH, Marino MV, Gastaca M, Lee JH, Kingham TP, D'Hondt M, Choi SH, Sutcliffe RP, Han HS, Tang CN, Pratschke J, Troisi RI, Wakabayashi G, Cherqui D, Giuliante F, Aghayan DL, Edwin B, Scatton O, Sugioka A, Long TCD, Fondevila C, Abu Hilal M, Ruzzenente A, Ferrero A, Herman P, Chen KH, Aldrighetti L, Goh BKP; International robotic and laparoscopic liver resection study group investigators*; International robotic and laparoscopic liver resection study group investigators. Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases. Hepatobiliary Surg Nutr. 2023 Apr 10;12(2):205-215. doi: 10.21037/hbsn-22-283. Epub 2023 Mar 17
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