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

TitleAn international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy
Authors
KeywordsLaparoscopic
Left lateral sectionectomy
Minimally invasive surgery
Robotic
Issue Date21-Dec-2022
PublisherSpringer
Citation
Surgical Endoscopy, 2023, v. 37, n. 5, p. 3439-3448 How to Cite?
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.


Persistent Identifierhttp://hdl.handle.net/10722/331238
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 1.120
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChong, Y-
dc.contributor.authorPrieto, M-
dc.contributor.authorGastaca, M-
dc.contributor.authorChoi, SH-
dc.contributor.authorSucandy, I-
dc.contributor.authorChiow, AKH-
dc.contributor.authorMarino, MV-
dc.contributor.authorWang, XY-
dc.contributor.authorEfanov, M-
dc.contributor.authorSchotte, H-
dc.contributor.authorD'Hondt, M-
dc.contributor.authorChoi, GH-
dc.contributor.authorKrenzien, F-
dc.contributor.authorSchmelzle, M-
dc.contributor.authorPratschke, J-
dc.contributor.authorKingham, TP-
dc.contributor.authorGiglio, M-
dc.contributor.authorTroisi, RI-
dc.contributor.authorLee, JH-
dc.contributor.authorLai, EC-
dc.contributor.authorTang, CN-
dc.contributor.authorFuks, D-
dc.contributor.authorD'Silva, M-
dc.contributor.authorHan, HS-
dc.contributor.authorKadam, P-
dc.contributor.authorSutcliffe, RP-
dc.contributor.authorLee, KF-
dc.contributor.authorChong, CC-
dc.contributor.authorCheung, TT-
dc.contributor.authorLiu, Q-
dc.contributor.authorLiu, R-
dc.contributor.authorGoh, BKP-
dc.date.accessioned2023-09-21T06:53:57Z-
dc.date.available2023-09-21T06:53:57Z-
dc.date.issued2022-12-21-
dc.identifier.citationSurgical Endoscopy, 2023, v. 37, n. 5, p. 3439-3448-
dc.identifier.issn0930-2794-
dc.identifier.urihttp://hdl.handle.net/10722/331238-
dc.description.abstract<h3>Background</h3><p>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.</p><h3>Methods</h3><p>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.</p><h3>Results</h3><p>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%, <em>p</em> = 0.009) and median blood loss was also statistically significantly lower in R-LLS at 50 (80) versus 100 (170) in L-LLS (<em>p</em> = 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 (<em>p</em> < 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.</p><h3>Conclusion</h3><p>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.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofSurgical Endoscopy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectLaparoscopic-
dc.subjectLeft lateral sectionectomy-
dc.subjectMinimally invasive surgery-
dc.subjectRobotic-
dc.titleAn international multicentre propensity score matched analysis comparing between robotic versus laparoscopic left lateral sectionectomy-
dc.typeArticle-
dc.identifier.doi10.1007/s00464-022-09790-x-
dc.identifier.scopuseid_2-s2.0-85144725590-
dc.identifier.volume37-
dc.identifier.issue5-
dc.identifier.spage3439-
dc.identifier.epage3448-
dc.identifier.eissn1432-2218-
dc.identifier.isiWOS:000905602900002-
dc.identifier.issnl0930-2794-

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