Propensity Score-matched Analysis Comparing Robotic Versus Laparoscopic Minor Liver Resections of the Anterolateral Segments: an International Multi-center Study of 10,517 Cases.

Journal

Annals of surgery

ISSN: 1528-1140

Titre abrégé: Ann Surg

Pays: United States

ID NLM: 0372354

Informations de publication

Date de publication:
05 Sep 2024

Historique:

medline: 5 9 2024

pubmed: 5 9 2024

entrez: 5 9 2024

Statut: aheadofprint

Résumé

To compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments. Robotic liver surgery has been gaining prominence over the years with increasing usage for a myriad of hepatic resections. Robotic liver resections(RLR) has demonstrated non-inferiority to laparoscopic(L)LR while illustrating advantages over conventional laparoscopy especially for technically difficult and major LR. However, the advantage of RMLR for the anterolateral(AL) (segments II, III, IVb, V and VI) segments, has not been clearly demonstrated. Between 2008 to 2022, 15,356 of 29,861 patients from 68 international centres underwent robotic(R) or laparoscopic minor liver resections (LMLR) for the AL segments Propensity score matching (PSM) analysis was performed for matched analysis. 10,517 patients met the study criteria of which 1,481 underwent RMLR and 9,036 underwent LMLR. A PSM cohort of 1,401 patients in each group were identified for analysis. Compared to the LMLR cohort, the RMLR cohort demonstrated significantly lower median blood loss (75ml vs. 100ml, P<0.001), decreased blood transfusion (3.1% vs. 5.4%, P=0.003), lower incidence of major morbidity (2.5% vs. 4.6%, P=0.004), lower proportion of open conversion (1.2% vs. 4.5%, P<0.001), shorter post operative stay (4 days vs. 5 days, P<0.001), but higher rate of 30-day readmission (3.5% vs. 2.1%, P=0.042). These results were then validated by a 1:2 PSM analysis. In the subset analysis for 3,614 patients with cirrhosis, RMLR showed lower median blood loss, decreased blood transfusion, lower open conversion and shorter post operative stay than LMLR. RMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.

Sections du résumé

OBJECTIVE OBJECTIVE

To compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments.

BACKGROUND BACKGROUND

Robotic liver surgery has been gaining prominence over the years with increasing usage for a myriad of hepatic resections. Robotic liver resections(RLR) has demonstrated non-inferiority to laparoscopic(L)LR while illustrating advantages over conventional laparoscopy especially for technically difficult and major LR. However, the advantage of RMLR for the anterolateral(AL) (segments II, III, IVb, V and VI) segments, has not been clearly demonstrated.

METHODS METHODS

Between 2008 to 2022, 15,356 of 29,861 patients from 68 international centres underwent robotic(R) or laparoscopic minor liver resections (LMLR) for the AL segments Propensity score matching (PSM) analysis was performed for matched analysis.

RESULTS RESULTS

10,517 patients met the study criteria of which 1,481 underwent RMLR and 9,036 underwent LMLR. A PSM cohort of 1,401 patients in each group were identified for analysis. Compared to the LMLR cohort, the RMLR cohort demonstrated significantly lower median blood loss (75ml vs. 100ml, P<0.001), decreased blood transfusion (3.1% vs. 5.4%, P=0.003), lower incidence of major morbidity (2.5% vs. 4.6%, P=0.004), lower proportion of open conversion (1.2% vs. 4.5%, P<0.001), shorter post operative stay (4 days vs. 5 days, P<0.001), but higher rate of 30-day readmission (3.5% vs. 2.1%, P=0.042). These results were then validated by a 1:2 PSM analysis. In the subset analysis for 3,614 patients with cirrhosis, RMLR showed lower median blood loss, decreased blood transfusion, lower open conversion and shorter post operative stay than LMLR.

CONCLUSION CONCLUSIONS

RMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.

Identifiants

DOI: 10.1097/SLA.0000000000006523 PMID: 39234677

pubmed: 39234677

doi: 10.1097/SLA.0000000000006523

pii: 00000658-990000000-01062

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Investigateurs

Mikel Prieto (M)

Ismael Chaoui (I)

Celine De Meyere (C)

Kit-Fai Lee (KF)

Kelvin K Ng (KK)

Pavel Tarakanov (P)

Anna Koroleva (A)

Nita Thiruchelvam (N)

Jae Young Jang (JY)

Masayuki Kojima (M)

Jaime Arthur Pirola Kruger (JAP)

Fabricio Ferreira Coelho (FF)

Victor Lopez-Lopez (V)

Margarida Casellas I Robert (M)

Roberto Montalti (R)

Mariano Giglio (M)

Boram Lee (B)

Mizelle D'Silva (M)

Hao-Ping Wang (HP)

Mansour Saleh (M)

Franco Pascual (F)

Mohammed Ghallab (M)

Zewei Chen (Z)

Shian Yu (S)

Simone Vani (S)

Francesco Ardito (F)

Ugo Giustizieri (U)

Davide Citterio (D)

Federico Mocchegiani (F)

Marco Colasanti (M)

Giammauro Berardi (G)

Yoelimar Guzmán (Y)

Kevin P Labadie (KP)

Kristin Goodsell (K)

Maria Conticchio (M)

Epameinondas Dogeas (E)

Emanuele F Kauffmann (EF)

Mario Giuffrida (M)

Daniele Sommacale (D)

Alexis Laurent (A)

Paolo Magistri (P)

Francois Cauchy (F)

Chung-Ngai Tang (CN)

Marco Barbara (M)

Duilio Pagano (D)

Qu Liu (Q)

Tiing-Foong Siow (TF)

Chetana Lim (C)

Phan Phuoc Nghia (PP)

Bernardo Dalla Valle (BD)

Yoshikuni Kawaguchi (Y)

Prashant Kadam (P)

Felix Krenzien (F)

Junhao Zheng (J)

Mirhasan Rahimli (M)

Asmund Avdem Fretland (AA)

Jacob Ghotbi (J)

Fei Liu (F)

Bo Li (B)

Federica Cipriani (F)

Gabriela Pilz da Cunha (GP)

Marc Besselink (M)

Kohei Mishima (K)

Jacopo Lanari (J)

Nora Nevermann (N)

Alessandro D Mazzotta (AD)

Francesco Izzo (F)

Informations de copyright

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.