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An international multicenter propensity-score matched and coarsened-exact matched analysis comparing robotic versus laparoscopic partial liver resections of the anterolateral segments.
Kadam, Prashant; Sutcliffe, Robert P; Scatton, Olivier; Sucandy, Iswanto; Kingham, T Peter; Liu, Rong; Choi, Gi Hong; Syn, Nicholas L; Gastaca, Mikel; Choi, Sung-Hoon; Chiow, Adrian K H; Marino, Marco V; Efanov, Mikhail; Lee, Jae-Hoon; Chong, Charing C; Tang, Chung-Ngai; Cheung, Tan-To; Pratschke, Johann; Wang, Xiaoying; Campos, Ricardo Robless; Ivanecz, Arpad; Park, James O; Rotellar, Fernando; Fuks, David; D'Hondt, Mathieu; Han, Ho-Seong; Troisi, Roberto I; Goh, Brian K P.
Afiliação
  • Kadam P; Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Sutcliffe RP; Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
  • Scatton O; Department of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, APHP, Sorbonne Université, Paris, France.
  • Sucandy I; AdventHealth Tampa, Digestive Health Institute, Tampa, Florida, USA.
  • Kingham TP; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York City, USA.
  • Liu R; Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
  • Choi GH; Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
  • Syn NL; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Ministry of Health Holdings, Singapore City, Singapore.
  • Gastaca M; Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain.
  • Choi SH; Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
  • Chiow AKH; Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore City, Singapore.
  • Marino MV; General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy.
  • Efanov M; Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy.
  • Lee JH; Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia.
  • Chong CC; Division of Hepato-Biliary and Pancreatic Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Tang CN; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
  • Cheung TT; Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
  • Pratschke J; Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China.
  • Wang X; Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Charité-Universitätsmedizin, Berlin, Germany.
  • Campos RR; Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.
  • Ivanecz A; Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain.
  • Park JO; Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia.
  • Rotellar F; Hepatobiliary Surgical Oncology, Department of Surgery, University of Washington Medical Center, Seattle, Washington, USA.
  • Fuks D; HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain.
  • D'Hondt M; Institute of Health Research of Navarra (IdisNA), Pamplona, Spain.
  • Han HS; Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France.
  • Troisi RI; Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, South Korea.
  • Goh BKP; Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium.
J Hepatobiliary Pancreat Sci ; 29(8): 843-854, 2022 Aug.
Article em En | MEDLINE | ID: mdl-35393759
ABSTRACT

BACKGROUND:

Robotic liver resections (RLR) may have the ability to address some of the drawbacks of laparoscopic liver resections (LLR) but few studies have done a head-to-head comparison of the outcomes after anterolateral segment resections by the two techniques.

METHODS:

A retrospective study was conducted of 3202 patients who underwent minimally invasive LR of the anterolateral liver segments at 26 international centres from 2005 to 2020. Two thousand six hundred and six cases met study criteria of which there were 358 RLR and 1868 LLR cases. Perioperative outcomes were compared between the two groups using a 13 Propensity Score Matched (PSM) and 11 Coarsened Exact Matched (CEM) analysis.

RESULTS:

Patients matched after 13 PSM (261 RLR vs 783 LLR) and 11 CEM (296 RLR vs 296 LLR) revealed no significant differences in length of stay, readmission rates, morbidity, mortality, and involvement of or close oncological margins. RLR surgeries were associated with significantly less blood loss (50 mL vs 100 ml, P < .001) and lower rates of open conversion on both PSM (1.5% vs 6.8%, P = .003) and CEM (1.4% vs 6.4%, P = .004) compared to LLR. Though PSM analysis showed RLR to have a longer operating time than LLR (170 minutes vs 160 minutes, P = .036), this difference proved to be insignificant on CEM (167 minutes vs 163 minutes, P = .575).

CONCLUSION:

This multicentre international combined PSM and CEM study showed that both RLR and LLR have equivalent perioperative outcomes when performed in selected patients at high-volume centres. The robotic approach was associated with significantly lower blood loss and allowed more surgeries to be completed in a minimally invasive fashion.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Laparoscopia / Carcinoma Hepatocelular / Procedimentos Cirúrgicos Robóticos / Neoplasias Hepáticas Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Laparoscopia / Carcinoma Hepatocelular / Procedimentos Cirúrgicos Robóticos / Neoplasias Hepáticas Idioma: En Ano de publicação: 2022 Tipo de documento: Article