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Article: Limited liver resections in the posterosuperior segments: international multicentre propensity score-matched and coarsened exact-matched analysis comparing the laparoscopic and robotic approaches

TitleLimited liver resections in the posterosuperior segments: international multicentre propensity score-matched and coarsened exact-matched analysis comparing the laparoscopic and robotic approaches
Authors
Issue Date2-Sep-2022
PublisherOxford University Press
Citation
British Journal of Surgery, 2022, v. 109, n. 11, p. 1140-1149 How to Cite?
Abstract

Background: Limited liver resections (LLRs) for tumours located in the posterosuperior segments of the liver are technically demanding procedures. This study compared outcomes of robotic (R) and laparoscopic (L) LLR for tumours located in the posterosuperior liver segments (IV, VII, and VIII). Methods: This was an international multicentre retrospective analysis of patients who underwent R-LLR or L-LLR at 24 centres between 2010 and 2019. Patient demographics, perioperative parameters, and postoperative outcomes were analysed; 1 : 3 propensity score matching (PSM) and 1 : 1 coarsened exact matching (CEM) were performed. Results: Of 1566 patients undergoing R-LLR and L-LLR, 983 met the study inclusion criteria. Before matching, 159 R-LLRs and 824 L-LLRs were included. After 1 : 3 PSM of 127 R-LLRs and 381 L-LLRs, comparison of perioperative outcomes showed that median blood loss (100 (i.q.r. 40-200) versus 200 (100-500) ml; P = 0.003), blood loss of at least 500 ml (9 (7.4 per cent) versus 94 (27.6 per cent); P<0.001), intraoperative blood transfusion rate (4 (3.1 per cent) versus 38 (10.0 per cent); P=0.025), rate of conversion to open surgery (1 (0.8 per cent) versus 30 (7.9 per cent); P=0.022), median duration of Pringle manoeuvre when applied (30 (20-46) versus 40 (25-58) min; P = 0.012), and median duration of operation (175 (130-255) versus 224 (155-300); P < 0.001) were lower in the R-LLR group compared with the L-LLR group. After 1 : 1 CEM of 104 R-LLRs with 104 L-LLRs, R-LLR was similarly associated with significantly reduced blood loss and a lower rate of conversion to open surgery. Conclusion: Based on a matched analysis of well selected patients, both robotic and laparoscopic access could be undertaken safely with good outcomes for tumours in the posterosuperior liver segments.


Persistent Identifierhttp://hdl.handle.net/10722/338786
ISSN
2021 Impact Factor: 11.122
2020 SCImago Journal Rankings: 2.202
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorD'Silva, Mizelle-
dc.contributor.authorHan, Ho-Seong-
dc.contributor.authorLiu, Rong-
dc.contributor.authorKingham, Thomas Peter-
dc.contributor.authorChoi, Gi-Hong-
dc.contributor.authorSyn, Nicholas Li-Xun-
dc.contributor.authorMikel, Prieto-
dc.contributor.authorChoi, Sung-Hoon-
dc.contributor.authorSucandy, Iswanto-
dc.contributor.authorChiow, Adrian Kah Heng-
dc.contributor.authorMarino, Marco Vito-
dc.contributor.authorEfanov, Mikhail-
dc.contributor.authorLee, Jae-Hoon-
dc.contributor.authorSutcliffe, Robert Peter-
dc.contributor.authorChong, Charing Ching Ning-
dc.contributor.authorTang, Chung Ngai-
dc.contributor.authorCheung, Tan-To-
dc.contributor.authorPratschke, Johann-
dc.contributor.authorWang, Xiaoying-
dc.contributor.authorPark, James Oh-
dc.contributor.authorChan, Chung-Yip-
dc.contributor.authorScatton, Olivier-
dc.contributor.authorRotellar, Fernando-
dc.contributor.authorTroisi, Roberto Ivan-
dc.contributor.authorD'Hondt, Mathieu-
dc.contributor.authorFuks, David-
dc.contributor.authorGoh, Brian Kim Poh-
dc.contributor.authorGastaca M-
dc.contributor.authorSchotte H-
dc.contributor.authorDe Meyere C-
dc.contributor.authorLai E.C-
dc.contributor.authorKrenzien F-
dc.contributor.authorSchmelzle M-
dc.contributor.authorKadam P-
dc.contributor.authorGiglio M-
dc.contributor.authorMontalti R-
dc.contributor.authorLiu Q-
dc.contributor.authorLee K.F-
dc.contributor.authorSalimgereeva D-
dc.contributor.authorAlikhanov R-
dc.contributor.authorLee L.S-
dc.contributor.authorJang J.Y-
dc.contributor.authorLim C-
dc.contributor.authorLabadie K.P-
dc.date.accessioned2024-03-11T10:31:31Z-
dc.date.available2024-03-11T10:31:31Z-
dc.date.issued2022-09-02-
dc.identifier.citationBritish Journal of Surgery, 2022, v. 109, n. 11, p. 1140-1149-
dc.identifier.issn0007-1323-
dc.identifier.urihttp://hdl.handle.net/10722/338786-
dc.description.abstract<p> <span>Background: Limited liver resections (LLRs) for tumours located in the posterosuperior segments of the liver are technically demanding procedures. This study compared outcomes of robotic (R) and laparoscopic (L) LLR for tumours located in the posterosuperior liver segments (IV, VII, and VIII). Methods: This was an international multicentre retrospective analysis of patients who underwent R-LLR or L-LLR at 24 centres between 2010 and 2019. Patient demographics, perioperative parameters, and postoperative outcomes were analysed; 1 : 3 propensity score matching (PSM) and 1 : 1 coarsened exact matching (CEM) were performed. Results: Of 1566 patients undergoing R-LLR and L-LLR, 983 met the study inclusion criteria. Before matching, 159 R-LLRs and 824 L-LLRs were included. After 1 : 3 PSM of 127 R-LLRs and 381 L-LLRs, comparison of perioperative outcomes showed that median blood loss (100 (i.q.r. 40-200) versus 200 (100-500) ml; P = 0.003), blood loss of at least 500 ml (9 (7.4 per cent) versus 94 (27.6 per cent); P<0.001), intraoperative blood transfusion rate (4 (3.1 per cent) versus 38 (10.0 per cent); P=0.025), rate of conversion to open surgery (1 (0.8 per cent) versus 30 (7.9 per cent); P=0.022), median duration of Pringle manoeuvre when applied (30 (20-46) versus 40 (25-58) min; P = 0.012), and median duration of operation (175 (130-255) versus 224 (155-300); P < 0.001) were lower in the R-LLR group compared with the L-LLR group. After 1 : 1 CEM of 104 R-LLRs with 104 L-LLRs, R-LLR was similarly associated with significantly reduced blood loss and a lower rate of conversion to open surgery. Conclusion: Based on a matched analysis of well selected patients, both robotic and laparoscopic access could be undertaken safely with good outcomes for tumours in the posterosuperior liver segments.</span> <br></p>-
dc.languageeng-
dc.publisherOxford University Press-
dc.relation.ispartofBritish Journal of Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.titleLimited liver resections in the posterosuperior segments: international multicentre propensity score-matched and coarsened exact-matched analysis comparing the laparoscopic and robotic approaches-
dc.typeArticle-
dc.identifier.doi10.1093/bjs/znac270-
dc.identifier.scopuseid_2-s2.0-85140144617-
dc.identifier.volume109-
dc.identifier.issue11-
dc.identifier.spage1140-
dc.identifier.epage1149-
dc.identifier.eissn1365-2168-
dc.identifier.isiWOS:000848665600001-
dc.identifier.issnl0007-1323-

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