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Sucandy, Iswanto; Rayman, Shlomi; Lai, Eric C.; Tang, Chung-Ngai; Chong, Yvette; Efanov, Mikhail; Fuks, David; Choi, Gi-Hong; Chong, Charing C.; Chiow, Adrian K. H.; Marino, Marco V.; Prieto, Mikel; Lee, Jae-Hoon; Kingham, T. Peter; D’Hondt, Mathieu; Troisi, Roberto I.; Choi, Sung Hoon; Sutcliffe, Robert P.; Cheung, Tan-To; Rotellar, Fernando; Park, James O.; Scatton, Olivier; Han, Ho-Seong; Pratschke, Johann; Wang, Xiaoying; Liu, Rong; Goh, Brian K. P.
Annals of surgical oncology, 12/2022, Letnik: 29, Številka: 13Journal Article
Background Controversies exist among liver surgeons regarding clinical outcomes of the laparoscopic versus the robotic approach for major complex hepatectomies. The authors therefore designed a study to examine and compare the perioperative outcomes of laparoscopic left hepatectomy or extended left hepatectomy (L-LH/L-ELH) versus robotic left hepatectomy or extended left hepatectomy (R-LH/R-ELH) using a large international multicenter collaborative database. Methods An international multicenter retrospective analysis of 580 patients undergoing L-LH/L-ELH or R-LH/R-ELH at 25 specialized hepatobiliary centers worldwide was undertaken. Propensity score-matching (PSM) was used at a 1:1 nearest-neighbor ratio according to 15 perioperative variables, including demographics, tumor characteristics, Child-Pugh score, presence of portal hypertension, multiple resections, histologic diagnosis, and Iwate difficulty grade. Results Before the PSM, 190 (32 %) patients underwent R-LH/R-ELH, and 390 (68 %) patients underwent L-LH/L-ELH. After the matching, 164 patients were identified in each arm without significant differences in demographics, preoperative variables, medical history, tumor pathology, tumor characteristics, or Iwate score. Regarding intra- and postoperative outcomes, the rebotic approach had significantly less estimated blood loss (EBL) (100 ml IQR 200 ml vs 200 ml IQR 235 ml; p = 0.029), fewer conversions to open operations ( n = 4 2.4 % vs n = 13, 7.9 %; p = 0.043), and a shorter hospital stay (6 days IQR 3 days vs 7 days IQR 3.3 days; p = 0.009). Conclusion Both techniques are safe and feasible in major hepatic resections. Compared with L-LH/L-ELH, R-LH/R-ELH is associated with less EBL, fewer conversions to open operations, and a shorter hospital stay.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Povezave do osebnih bibliografij avtorjev | Povezave do podatkov o raziskovalcih v sistemu SICRIS |
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Vir: Osebne bibliografije
in: SICRIS
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