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  • An international multicentr...
    Chong, Yvette; Prieto, Mikel; Gastaca, Mikel; Choi, Sung-Hoon; Sucandy, Iswanto; Chiow, Adrian K. H.; Marino, Marco V.; Wang, Xiaoying; Efanov, Mikhail; Schotte, Henri; D’Hondt, Mathieu; Choi, Gi-Hong; Krenzien, Felix; Schmelzle, Moritz; Pratschke, Johann; Kingham, T. Peter; Giglio, Mariano; Troisi, Roberto I.; Lee, Jae Hoon; Lai, Eric C.; Tang, Chung Ngai; Fuks, David; D’Silva, Mizelle; Han, Ho-Seong; Kadam, Prashant; Sutcliffe, Robert P.; Lee, Kit-Fai; Chong, Charing C.; Cheung, Tan-To; Liu, Qiu; Liu, Rong; Goh, Brian K. P.

    Surgical endoscopy, 05/2023, Letnik: 37, Številka: 5
    Journal Article

    Background Left lateral sectionectomy (LLS) is one of the most commonly performed minimally invasive liver resections. While laparoscopic (L)-LLS is a well-established technique, over traditional open resection, it remains controversial if robotic (R)-LLS provides any advantages of L-LLS. Methods A post hoc analysis of 997 patients from 21 international centres undergoing L-LLS or R-LLS from 2006 to 2020 was conducted. A total of 886 cases (214 R-LLS, 672 L-LLS) met study criteria. 1:1 and 1:2 propensity score matched (PSM) comparison was performed between R-LLS & L-LLS. Further subset analysis by Iwate difficulty was also performed. Outcomes measured include operating time, blood loss, open conversion, readmission rates, morbidity and mortality. Results Comparison between R-LLS and L-LLS after PSM 1:2 demonstrated statistically significantly lower open conversion rate in R-LLS than L-LLS (0.6% versus 5%, p  = 0.009) and median blood loss was also statistically significantly lower in R-LLS at 50 (80) versus 100 (170) in L-LLS ( p  = 0.011) after PSM 1:1 although there was no difference in the blood transfusion rate. Pringle manoeuvre was also found to be used more frequently in R-LLS, with 53(24.8%) cases versus to 84(12.5%) L-LLS cases ( p  < 0.001). There was no significant difference in the other key perioperative outcomes such as operating time, length of stay, postoperative morbidity, major morbidity and 90-day mortality between both groups. Conclusion R-LLS was associated with similar key perioperative outcomes compared to L-LLS. It was also associated with significantly lower blood loss and open conversion rates compared to L-LLS.