Publicaciones científicas
An international multicenter propensity-score matched and coarsened-exact matched analysis comparing between robotic versus laparoscopic partial liver resections of the anterolateral segments
Prashant Kadam 1 , Robert P Sutcliffe 1 , Olivier Scatton 2 , Iswanto Sucandy 3 , T Peter Kingham 4 , Rong Liu 5 , Gi Hong Choi 6 , Nicholas L Syn 7 , Mikel Gastaca 8 , Sung-Hoon Choi 9 , Adrian K H Chiow 10 , Marco V Marino 11 , Mikhail Efanov 12 , Jae-Hoon Lee 13 , Charing C Chong 14 , Chung-Ngai Tang 15 , Tan-To Cheung 16 , Johann Pratschke 17 , Xiaoying Wang 18 , Ricardo Robless Campos 19 , Arpad Ivanecz 20 , James O Park 21 , Fernando Rotellar 22 , David Fuks 23 , Mathieu D'Hondt 24 , Ho-Seong Han 25 , Roberto I Troisi 26 , Brian K P Goh 27 , International robotic and laparoscopic liver resection study group investigators
Background: Robotic liver resections RLR may have the ability to address some of the drawbacks of laparoscopic(L)LR 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. 2606 cases met study criteria of which there were 358 RLR and 1868 LLR. Peri-operative outcomes were compared between the two groups using a 1:3 Propensity Score Matched(PSM) and 1:1 Coarsened Exact Matched(CEM) analysis.
Results: Patients matched after 1:3 PSM(261 RLR vs. 783 LLR) and 1:1 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(50ml vs. 100ml, p<0.001) and lower rates of open conversion on both PSM(1.5% vs. 6.8%, p=0.003) and CEM(1.4% vs. 6.4%, p=0.004) compared to LLR. Though PSM analysis showed RLR to have a longer operating time than LLR(170 min vs. 160 min, p=0.036), this difference proved to be insignificant on CEM(167 min vs. 163 min. p=0.575).
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.
CITA DEL ARTÍCULO J Hepatobiliary Pancreat Sci. 2022 Aug;29(8):843-854. doi: 10.1002/jhbp.1149. Epub 2022 Apr 27.
Nuestros autores
