An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy.
Author
Chong, YvettePrieto, Mikel
Gastaca, Mikel
Choi, Sung-Hoon
Sucandy, Iswanto
Chiow, Adrian K H
Marino, Marco V
Wang, Xiaoying
Efanov, Mikhail
Schotte, Henri
D'Hondt, Mathieu
Choi, Gi-Hong
Krenzien, Felix
Schmelzle, Moritz
Pratschke, Johann
Kingham, T Peter
Giglio, Mariano
Troisi, Roberto I
Lee, Jae Hoon
Lai, Eric C
Tang, Chung Ngai
Fuks, David
D'Silva, Mizelle
Han, Ho-Seong
Kadam, Prashant
Sutcliffe, Robert P
Lee, Kit-Fai
Chong, Charing C
Cheung, Tan-To
Liu, Qiu
Liu, Rong
Goh, Brian K P
Publication date
2022-12-21
Metadata
Show full item recordAbstract
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.Citation
Chong Y, Prieto M, Gastaca M, Choi SH, Sucandy I, Chiow AKH, Marino MV, Wang X, Efanov M, Schotte H, D'Hondt M, Choi GH, Krenzien F, Schmelzle M, Pratschke J, Kingham TP, Giglio M, Troisi RI, Lee JH, Lai EC, Tang CN, Fuks D, D'Silva M, Han HS, Kadam P, Sutcliffe RP, Lee KF, Chong CC, Cheung TT, Liu Q, Liu R, Goh BKP; International robotic and laparoscopic liver resection study group investigators. An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy. Surg Endosc. 2023 May;37(5):3439-3448. doi: 10.1007/s00464-022-09790-x. Epub 2022 Dec 21.Type
ArticleAdditional Links
https://link.springer.com/journal/464PMID
36542135Journal
Surgical EndoscopyPublisher
Springerae974a485f413a2113503eed53cd6c53
10.1007/s00464-022-09790-x