• Jie Hu, Yuxin Guo, Xiaoying Wang, Marcus Yeow, Andrew G R Wu, David Fuks, Olivier Soubrane, Safi Dokmak, Salvatore Gruttadauria, Giuseppe Zimmitti, Francesca Ratti, Yutaro Kato, Olivier Scatton, Paulo Herman, Davit L Aghayan, Marco V Marino, Roland S Croner, Vincenzo Mazzaferro, Adrian K H Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung Hoon Choi, Jae Hoon Lee, Mikel Gastaca, Marco Vivarelli, Felice Giuliante, Andrea Ruzzenente, Chee-Chien Yong, Mengqiu Yin, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, ValleRaffaele DallaRDHepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy., Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Alejandro Mejia, James O Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Kiyoshi Hasegawa, Rutger-Jan Swijnenburg, Robert P Sutcliffe, Johann Pratschke, LaiEric C HECHDepartment of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China., Charing C N Chong, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, T Peter Kingham, Moritz Schmelzle, Jason Hawksworth, Yufu Peng, Alessandro Ferrero, Giuseppe Maria Ettorre, Daniel Cherqui, Xiao Liang, Go Wakabayashi, Roberto I Troisi, Umberto Cillo, Tan-To Cheung, Motokazu Sugimoto, Atsushi Sugioka, Ho-Seong Han, Tran Cong Duy Long, HilalMohammad AbuMADepartment of Surgery, Fondazione Poliambulanza, Brescia, Italy.Department of Surgery, University Hospital Southampton, United Kingdom., Wanguang Zhang, Yonggang Wei, Kuo-Hsin Chen, Luca Aldrighetti, Bjorn Edwin, Rong Liu, GohBrian K PBKP0000-0001-8218-4576Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.Division of General Surgery, Far Eastern Memorial Hospital, New Taipei City., and International robotic and laparoscopic liver resection study group investigators.
• Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
• Ann. Surg. 2024 Sep 5.

ObjectiveTo compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments.BackgroundRobotic 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.MethodsBetween 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.Results10,517 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.ConclusionRMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

6 keywords...

hide…