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An international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy

Authors
 Yvette Chong  ;  Mikel Prieto  ;  Mikel Gastaca  ;  Sung-Hoon Choi  ;  Iswanto Sucandy  ;  Adrian K H Chiow  ;  Marco V Marino  ;  Xiaoying Wang  ;  Mikhail Efanov  ;  Henri Schotte  ;  Mathieu D'Hondt  ;  Gi-Hong Choi  ;  Felix Krenzien  ;  Moritz Schmelzle  ;  Johann Pratschke  ;  T Peter Kingham  ;  Mariano Giglio  ;  Roberto I Troisi  ;  Jae Hoon Lee  ;  Eric C Lai  ;  Chung Ngai Tang  ;  David Fuks  ;  Mizelle D'Silva  ;  Ho-Seong Han  ;  Prashant Kadam  ;  Robert P Sutcliffe  ;  Kit-Fai Lee  ;  Charing C Chong  ;  Tan-To Cheung  ;  Qiu Liu 23  ;  Rong Liu  ;  Brian K P Goh  ;  International robotic and laparoscopic liver resection study group investigators 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.37(5) : 3439-3448, 2023-05 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2023-05
MeSH
Hepatectomy / methods ; Humans ; Laparoscopy* / methods ; Length of Stay ; Liver Neoplasms* / surgery ; Postoperative Complications / epidemiology ; Postoperative Complications / etiology ; Postoperative Complications / surgery ; Propensity Score ; Retrospective Studies ; Robotic Surgical Procedures* / methods ; Treatment Outcome
Keywords
Laparoscopic ; Left lateral sectionectomy ; Minimally invasive surgery ; Robotic
Abstract
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.
Full Text
https://link.springer.com/article/10.1007/s00464-022-09790-x
DOI
10.1007/s00464-022-09790-x
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/198738
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