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Robotic Versus Open Minor Liver Resections of the Posterosuperior Segments: A Multinational, Propensity Score-Matched Study

 Carolijn L. Nota  ;  Yanghee Woo  ;  Mustafa Raoof  ;  Thomas Boerner  ;  I. Quintus Molenaar  ;  Gi Hong Choi  ;  T. Peter Kingham  ;  Karen Latorre  ;  Inne H. M. Borel Rinkes  ;  Jeroen Hagendoorn  ;  Yuman Fong 
 Annals of Surgical Oncology, Vol.26(2) : 583-590, 2019 
Journal Title
 Annals of Surgical Oncology 
Issue Date
Aged ; Carcinoma, Hepatocellular/pathology ; Carcinoma, Hepatocellular/surgery* ; Female ; Follow-Up Studies ; Hepatectomy/mortality* ; Humans ; Laparoscopy/mortality* ; Length of Stay ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Postoperative Complications* ; Propensity Score* ; Retrospective Studies ; Robotic Surgical Procedures/mortality* ; Survival Rate ; Treatment Outcome
BACKGROUND: Minor liver resections of posterosuperior segments (1, 4A, 7, 8) are challenging to perform laparoscopically and are mainly performed using an open approach. We determined the feasibility of robotic resections of posterosuperior segments and compared short-term outcomes with the open approach. METHODS: Data on open and robotic minor (≤ 3 segments) liver resections including the posterosuperior segments, performed between 2009 and 2016, were collected retrospectively from four hospitals. Robotic and open liver resections were compared, before and after propensity score matching. RESULTS: In total, 51 robotic and 145 open resections were included. After matching, 31 robotic resections were compared with 31 open resections. Median hospital stay was 4 days (interquartile range [IQR] 3-7) for the robotic group, versus 8 days (IQR 6-10) for the open group (p < 0.001). Median operative time was 222 min (IQR 164-505) for robotic cases versus 231 min (IQR 190-301) for open cases (p = 0.668). Median estimated blood loss was 200 mL (IQR 100-400) versus 300 mL (IQR 125-750), respectively (p = 0.212). In the robotic group, one patient (3%) had a major complication, versus three patients (10%) in the open group (p = 0.612). Readmissions were similar-10% in the robotic group versus 6% in the open group (p > 0.99). There was no mortality in either group. CONCLUSION: Minor robotic liver resections of the posterosuperior segments are safe and feasible and display a shorter length of stay than open resections in selected patients at expert centers.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
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