Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments-Reference-Cited by-同舟云学术

Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments

Published:2023-07-24 Issue:2 Volume:279 Page:297-305
ISSN:0003-4932
Container-title:Annals of Surgery
language:en
Short-container-title:

Author:

Krenzien Felix¹,Schmelzle Moritz¹,Pratschke Johann¹,Feldbrügge Linda¹,Liu Rong²,Liu Qu²,Zhang Wanguang³,Zhao Joseph J.⁴,Tan Hwee-Leong⁴,Cipriani Federica⁵,Hoogteijling Tijs J.⁶,Aghayan Davit L.⁷,Fretland Åsmund A.⁷,Siow Tiing Foong⁸,Lim Chetana⁹,Scatton Olivier⁹,Herman Paulo¹⁰,Coelho Fabricio F.¹⁰,Marino Marco V.¹¹¹²,Mazzaferro Vincenzo¹³,Chiow Adrian K.H.¹⁴,Sucandy Iswanto¹⁵,Ivanecz Arpad¹⁶,Choi Sung Hoon¹⁷,Lee Jae Hoon¹⁸,Gastaca Mikel¹⁹,Vivarelli Marco²⁰,Giuliante Felice²¹,Dalla Valle Bernardo²²,Ruzzenente Andrea²²,Yong Chee-Chien²³,Chen Zewei²⁴,Yin Mengqiu²⁴,Fondevila Constantino²⁵²⁶,Efanov Mikhail²⁷,Morise Zenichi²⁸,Di Benedetto Fabrizio²⁹,Brustia Raffaele³⁰,Dalla Valle Raffaele³¹,Boggi Ugo³²,Geller David³³,Belli Andrea³⁴,Memeo Riccardo³⁵,Gruttadauria Salvatore³⁶³⁷,Mejia Alejandro³⁸,Park James O.³⁹,Rotellar Fernando⁴⁰,Choi Gi-Hong⁴¹,Robles-Campos Ricardo⁴²,Wang Xiaoying⁴³,Sutcliffe Robert P.⁴⁴,Hasegawa Kiyoshi⁴⁵,Tang Chung-Ngai⁴⁶,Chong Charing C. N.⁴⁷,Lee Kit-Fai⁴⁷,Meurs Juul⁴⁸,D’Hondt Mathieu⁴⁸,Monden Kazuteru⁴⁹,Lopez-Ben Santiago⁵⁰,Kingham T. Peter⁵¹,Ferrero Alessandro⁵²,Ettorre Giuseppe M.⁵³,Pascual Franco⁵⁴,Cherqui Daniel⁵⁴,Zheng Junhao⁵⁵,Liang Xiao⁵⁵,Soubrane Olivier⁵⁶,Wakabayashi Go⁵⁷,Troisi Roberto I.⁵⁸,Cheung Tan-To⁵⁹,Kato Yutaro⁶⁰,Sugioka Atsushi⁶⁰,Dokmak Safi⁶¹,D’Silva Mizelle⁶²,Han Ho-Seong⁶²,Nghia Phan Phuoc⁶³,Long Tran Cong duy⁶³,Hilal Mohammad Abu⁶⁶⁴,Chen Kuo-Hsin⁸,Fuks David⁵⁶,Aldrighetti Luca⁵,Edwin Bjørn⁷,Goh Brian K. P.⁴⁶⁵,

Affiliation:

1. Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, and Berlin Institute of Health, Berlin, Germany

2. Faculty of Hepatopancreatobiliary Surgery, the First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China

3. Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

4. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore

5. Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy

6. Department of Surgery, Fondazione Poliambulanza, Brescia, Italy

7. Department of HPB Surgery, The Intervention Centre, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway

8. Department of Surgery, Division of General Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan

9. Department of Digestive, HBP and Liver Transplantation, Hopital Pitie-Salpetriere, Sorbonne Universite, Paris, France

10. Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil

11. General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy

12. Oncologic Surgery Department, P. Giaccone University Hospital, Palermo, Italy

13. HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy

14. Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore

15. Digestive Health Institute, AdventHealth Tampa, Tampa, FL

16. Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia

17. Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

18. Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

19. Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain

20. HPB Surgery and Transplantation Unit, Department of Experimental and Clinical Medicine, United Hospital of Ancona, Polytechnic University of Marche, Ancona, Italy

21. Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy

22. General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, GB Rossi Hospital, Verona, Italy

23. Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan

24. Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China

25. General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain

26. General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, CIBERehd, Madrid, Spain

27. Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia

28. Department of Surgery, Okazaki Medical Center, Fujita Health University School of Medicine, Okazaki, Japan

29. HPB Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy

30. Department of Digestive and Hepatobiliary and Pancreatic Surgery, AP-HP, Henri-Mondor Hospital, Creteil, France

31. Hepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy

32. Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

33. Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

34. Department of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center—IRCCS-G. Pascale, Naples, Italy

35. Unit of Hepato-Pancreatc-Biliary Surgery, “F. Miulli” General Regional Hospital, Acquaviva delle Fonti, Bari, Italy

36. Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy

37. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy

38. The Liver Institute, Methodist Dallas Medical Center, Dallas, TX

39. Department of Surgery, University of Washington Medical Center, Seattle, WA

40. HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain & Institute of Health Research of Navarra (IdisNA), Pamplona, Spain

41. Department of Surgery, Division of Hepatopancreatobiliary Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

42. Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de la Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain

43. Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China

44. Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

45. Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

46. Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China

47. Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China

48. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium

49. Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan

50. Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain

51. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY

52. Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy

53. Division of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy

54. Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France

55. Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China

56. Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France

57. Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan

58. Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy

59. Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China

60. Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan

61. Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, University Paris Cite, Clichy, France

62. Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, Korea

63. Department of Hepato-Pancreato-Biliary Surgery, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam

64. Department of Surgery, University Hospital Southampton, Southampton, UK

65. Surgery Academic Clinical Programme, Duke-National University of Singapore Medical School, Singapore, Singapore

Abstract

Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: and 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50–200) days vs 150 mL (IQR: 50–350); P<0.001] and a shorter operative time (188 min (IQR: 140–270) vs 222 min (IQR: 158–300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis—lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48–200) vs 160 mL (IQR: 50–400); P<0.001], and shorter operative time [190 min (IQR: 141–258) vs 230 min (IQR: 160–312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

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