Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments An International Multicenter Study
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Citações na Scopus
3
Tipo de produção
article
Data de publicação
2024
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
KRENZIEN, Felix
SCHMELZLE, Moritz
PRATSCHKE, Johann
FELDBRUEGGE, Linda
LIU, Rong
LIU, Qu
ZHANG, Wanguang
ZHAO, Joseph J.
TAN, Hwee-Leong
CIPRIANI, Federica
Citação
ANNALS OF SURGERY, v.279, n.2, p.297-305, 2024
Resumo
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.
Palavras-chave
laparoscopic liver resection, robotic liver resection, posterosuperior liver segments, liver cirrhosis, minimally-invasive hepatectomy
Referências
- Alvarez FA, 2016, WORLD J GASTRO SURG, V8, P407, DOI 10.4240/wjgs.v8.i6.407
- Boggi U, 2015, UPDATES SURG, V67, P177, DOI 10.1007/s13304-015-0304-5
- Cheung TT, 2018, LIVER CANCER, V7, P28, DOI 10.1159/000481834
- Chin KM, 2022, J GASTROINTEST SURG, V26, P1041, DOI 10.1007/s11605-021-05226-4
- Chiow AKH, 2021, BRIT J SURG, V108, P1513, DOI 10.1093/bjs/znab321
- Choi SH, 2022, SURG ENDOSC, V36, P9204, DOI 10.1007/s00464-022-09404-6
- Chong CC, 2022, JAMA SURG, V157, P436, DOI 10.1001/jamasurg.2022.0161
- Chong Y, 2022, SURG ENDOSC, V36, P591, DOI 10.1007/s00464-021-08321-4
- Chua D, 2021, BRIT J SURG, V108, P351, DOI 10.1093/bjs/znaa118
- Clavien PA, 2009, ANN SURG, V250, P187, DOI 10.1097/SLA.0b013e3181b13ca2
- D'Hondt M, 2018, SURG ENDOSC, V32, P1478, DOI 10.1007/s00464-017-5835-z
- D'Silva M, 2022, BRIT J SURG, V109, P1140, DOI 10.1093/bjs/znac270
- Feldbrügge L, 2022, SURG ENDOSC, V36, P2842, DOI 10.1007/s00464-021-08572-1
- Feldbrügge L, 2020, HPB, V22, P1191, DOI 10.1016/j.hpb.2019.11.006
- Fung AKY, 2019, HEPATOBIL SURG NUTR, V8, P264, DOI 10.21037/hbsn.2018.12.12
- Goh BKP, 2021, SURG ENDOSC, V35, P5231, DOI 10.1007/s00464-020-08018-0
- Haber PK, 2019, SURG ONCOL, V28, P140, DOI 10.1016/j.suronc.2018.12.001
- Hobeika C, 2020, BRIT J SURG, V107, P268, DOI 10.1002/bjs.11406
- Ibuki S, 2022, ANN SURG, V275, P940, DOI 10.1097/SLA.0000000000004434
- Kabir T, 2022, BRIT J SURG, V109, P21, DOI [10.1093/bjs/znab376, 10.1093/bis/znab376]
- Kadam P, 2022, J HEPATO-BIL-PAN SCI, V29, P843, DOI 10.1002/jhbp.1149
- Kamarajah SK, 2021, SCAND J SURG, V110, P290, DOI 10.1177/1457496920925637
- Kawaguchi Y, 2018, ANN SURG, V267, P13, DOI 10.1097/SLA.0000000000002176
- Krenzien Felix, 2022, Ann Surg Open, V3, pe131, DOI 10.1097/AS9.0000000000000131
- Krenzien F, 2018, J HEPATO-BIL-PAN SCI, V25, P403, DOI 10.1002/jhbp.576
- Lee W, 2016, SURGERY, V160, P1219, DOI 10.1016/j.surg.2016.05.009
- Linn YL, 2023, J HEPATO-BIL-PAN SCI, V30, P36, DOI 10.1002/jhbp.1211
- Machairas N, 2018, SURG LAPARO ENDO PER, V28, P203, DOI 10.1097/SLE.0000000000000562
- Montalti R, 2016, SURG ENDOSC, V30, P1004, DOI 10.1007/s00464-015-4284-9
- Morikawa T, 2019, SURG TODAY, V49, P214, DOI 10.1007/s00595-018-1719-7
- Nagino M, 2021, ANN SURG, V274, P1, DOI 10.1097/SLA.0000000000004808
- Nota CLMA, 2016, J SURG RES, V206, P133, DOI 10.1016/j.jss.2016.06.079
- REICH H, 1991, OBSTET GYNECOL, V78, P956
- Strasberg SM, 2005, J HEPATO-BILIARY-PAN, V12, P351, DOI 10.1007/s00534-005-0999-7
- Teo JY, 2015, HEPATOBIL SURG NUTR, V4, P379, DOI 10.3978/j.issn.2304-3881.2015.06.06
- Troisi RI, 2021, BRIT J SURG, V108, P196, DOI 10.1093/bjs/znaa041
- Troisi RI, 2013, INT J MED ROBOT COMP, V9, P160, DOI 10.1002/rcs.1495
- Wakabayashi G, 2022, J HEPATO-BIL-PAN SCI, V29, P6, DOI 10.1002/jhbp.1091
- Wakabayashi G, 2016, HEPATOL SURG NUTR, V5, P281, DOI 10.21037/hbsn.2016.03.03
- Wakabayashi G, 2015, ANN SURG, V261, P619, DOI 10.1097/SLA.0000000000001184
- Yang HY, 2022, BRIT J SURG, V109, P311, DOI 10.1093/bjs/znab463
- Ziogas IA, 2021, SURG ENDOSC, V35, P524, DOI 10.1007/s00464-020-08008-2