Publicaciones científicas
Propensity Score-matched Analysis Comparing Robotic Versus Laparoscopic Minor Liver Resections of the Anterolateral Segments: an International Multi-center Study of 10,517 Cases
Jie Hu 1 , Yuxin Guo 2 , Xiaoying Wang 1 , Marcus Yeow 3 , Andrew G R Wu 3 , David Fuks 4 , Olivier Soubrane 4 , Safi Dokmak 5 , Salvatore Gruttadauria 6 , Giuseppe Zimmitti 7 , Francesca Ratti 8 , Yutaro Kato 9 , Olivier Scatton 10 , Paulo Herman 11 , Davit L Aghayan 12 , Marco V Marino 13 , Roland S Croner 14 , Vincenzo Mazzaferro 15 , Adrian K H Chiow 16 , Iswanto Sucandy 17 , Arpad Ivanecz 18 , Sung Hoon Choi 19 , Jae Hoon Lee 20 , Mikel Gastaca 21 , Marco Vivarelli 22 , Felice Giuliante 23 , Andrea Ruzzenente 24 , Chee-Chien Yong 25 , Mengqiu Yin 26 , Constantino Fondevila 27 , Mikhail Efanov 28 , Zenichi Morise 29 , Fabrizio Di Benedetto 30 , Raffaele Brustia 31 , Raffaele Dalla Valle 32 , Ugo Boggi 33 , David Geller 34 , Andrea Belli 35 , Riccardo Memeo 36 , Alejandro Mejia 37 , James O Park 38 , Fernando Rotellar 39 , Gi-Hong Choi 40 , Ricardo Robles-Campos 41 , Kiyoshi Hasegawa 42 , Rutger-Jan Swijnenburg 43 , Robert P Sutcliffe 44 , Johann Pratschke 45 , Eric C H Lai 46 , Charing C N Chong 47 , Mathieu D'Hondt 48 , Kazuteru Monden 49 , Santiago Lopez-Ben 50 , T Peter Kingham 51 , Moritz Schmelzle 52 , Jason Hawksworth 53 , Yufu Peng 54 , Alessandro Ferrero 55 , Giuseppe Maria Ettorre 56 , Daniel Cherqui 57 , Xiao Liang 58 , Go Wakabayashi 59 , Roberto I Troisi 60 , Umberto Cillo 61 , Tan-To Cheung 62 , Motokazu Sugimoto 63 , Atsushi Sugioka 9 , Ho-Seong Han 64 , Tran Cong Duy Long 65 , Mohammad Abu Hilal 7 66 , Wanguang Zhang 67 , Yonggang Wei 54 , Kuo-Hsin Chen 68 , Luca Aldrighetti 8 , Bjorn Edwin 12 , Rong Liu 69 , Brian K P Goh 2 68 ; International robotic and laparoscopic liver resection study group investigators
Objective: To compare the outcomes of robotic minor liver resections (RMLR) versus laparoscopic (L) MLR of the anterolateral segments.
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: 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: 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: RMLR demonstrated statistically significant advantages over LMLR even for resections in the AL segments although most of the observed clinical differences were minimal.
CITA DEL ARTÍCULO Ann Surg. 2024 Sep 5. doi: 10.1097/SLA.0000000000006523
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