Robotic versus open hemihepatectomy: a propensity score-matched study
Background Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepate...
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| Veröffentlicht in: | Surgical endoscopy 2021-05, Vol.35 (5), p.2316-2323 |
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| creator | Lee, Kit-fai Chong, Charing Cheung, Sunny Wong, John Fung, Andrew Lok, Hon-ting Lo, Eugene Lai, Paul |
| description | Background
Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.
Methods
Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio.
Results
After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min,
P
|
| doi_str_mv | 10.1007/s00464-020-07645-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2460770064</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2460770064</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-3ba5ca20316a669dab55208d81c03dc6081cdcff79808560db0525eb6d6bde13</originalsourceid><addsrcrecordid>eNp9kE1LAzEQhoMotlb_gAdZ8OIlOkk2ya43KfUDBEF6D9kka7d0uzXZle6_N3WrggdPMzDPvDM8CJ0TuCYA8iYApCLFQAGDFCnH2wM0JimjmFKSHaIx5AwwlXk6QichLCHyOeHHaMQYybgUcoxmr03RtJVJPpwPXUiajVsnC1dXC7fRrTNtU_e3iU42fjcJVdsnwTTe4Vq3ZuFsEtrO9qfoqNSr4M72dYLm97P59BE_vzw8Te-esWGSt5gVmhtNgRGhhcitLjinkNmMGGDWCIiNNWUp8wwyLsAWwCl3hbCisI6wCboaYuM3750LraqrYNxqpdeu6YKiqQApAUQa0cs_6LLp_Do-pygnPJWCSRYpOlDGNyF4V6qNr2rte0VA7RyrwbGKjtWXY7WNSxf76K6onf1Z-ZYaATYAIY7Wb87_3v4n9hMk6ody</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2515476373</pqid></control><display><type>article</type><title>Robotic versus open hemihepatectomy: a propensity score-matched study</title><source>Springer Nature - Complete Springer Journals</source><creator>Lee, Kit-fai ; Chong, Charing ; Cheung, Sunny ; Wong, John ; Fung, Andrew ; Lok, Hon-ting ; Lo, Eugene ; Lai, Paul</creator><creatorcontrib>Lee, Kit-fai ; Chong, Charing ; Cheung, Sunny ; Wong, John ; Fung, Andrew ; Lok, Hon-ting ; Lo, Eugene ; Lai, Paul</creatorcontrib><description>Background
Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.
Methods
Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio.
Results
After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min,
P
< 0.001) but the postoperative hospital stay was significantly shorter (median 5 days vs 6.5 days,
P
= 0.040) in the robotic group. When right and left hepatectomy were analyzed separately, the advantage of shorter hospital stay remained in left but not right hepatectomy. For patients with hepatocellular carcinoma, there was no difference between the two groups in 5-year overall and disease-free survival.
Conclusion
Compared with the open approach, robotic hemihepatectomy has longer operation time but shorter hospital stay. Thus, use of robot is feasible and effective in hemihepatectomy with the benefit of shorter hospital stay.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-020-07645-x</identifier><identifier>PMID: 33185767</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Abdominal Surgery ; Dissection ; Endoscopy ; Gastroenterology ; Gynecology ; Hepatectomy ; Hepatology ; Hospitals ; Laparoscopy ; Liver ; Liver cancer ; Liver cirrhosis ; Medicine ; Medicine & Public Health ; Patients ; Proctology ; Robotics ; Robots ; Surgery ; Veins & arteries</subject><ispartof>Surgical endoscopy, 2021-05, Vol.35 (5), p.2316-2323</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-3ba5ca20316a669dab55208d81c03dc6081cdcff79808560db0525eb6d6bde13</citedby><cites>FETCH-LOGICAL-c375t-3ba5ca20316a669dab55208d81c03dc6081cdcff79808560db0525eb6d6bde13</cites><orcidid>0000-0003-0637-0291</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-020-07645-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-020-07645-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33185767$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Kit-fai</creatorcontrib><creatorcontrib>Chong, Charing</creatorcontrib><creatorcontrib>Cheung, Sunny</creatorcontrib><creatorcontrib>Wong, John</creatorcontrib><creatorcontrib>Fung, Andrew</creatorcontrib><creatorcontrib>Lok, Hon-ting</creatorcontrib><creatorcontrib>Lo, Eugene</creatorcontrib><creatorcontrib>Lai, Paul</creatorcontrib><title>Robotic versus open hemihepatectomy: a propensity score-matched study</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.
Methods
Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio.
Results
After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min,
P
< 0.001) but the postoperative hospital stay was significantly shorter (median 5 days vs 6.5 days,
P
= 0.040) in the robotic group. When right and left hepatectomy were analyzed separately, the advantage of shorter hospital stay remained in left but not right hepatectomy. For patients with hepatocellular carcinoma, there was no difference between the two groups in 5-year overall and disease-free survival.
Conclusion
Compared with the open approach, robotic hemihepatectomy has longer operation time but shorter hospital stay. Thus, use of robot is feasible and effective in hemihepatectomy with the benefit of shorter hospital stay.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Dissection</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatectomy</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Laparoscopy</subject><subject>Liver</subject><subject>Liver cancer</subject><subject>Liver cirrhosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Proctology</subject><subject>Robotics</subject><subject>Robots</subject><subject>Surgery</subject><subject>Veins & arteries</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gAdZ8OIlOkk2ya43KfUDBEF6D9kka7d0uzXZle6_N3WrggdPMzDPvDM8CJ0TuCYA8iYApCLFQAGDFCnH2wM0JimjmFKSHaIx5AwwlXk6QichLCHyOeHHaMQYybgUcoxmr03RtJVJPpwPXUiajVsnC1dXC7fRrTNtU_e3iU42fjcJVdsnwTTe4Vq3ZuFsEtrO9qfoqNSr4M72dYLm97P59BE_vzw8Te-esWGSt5gVmhtNgRGhhcitLjinkNmMGGDWCIiNNWUp8wwyLsAWwCl3hbCisI6wCboaYuM3750LraqrYNxqpdeu6YKiqQApAUQa0cs_6LLp_Do-pygnPJWCSRYpOlDGNyF4V6qNr2rte0VA7RyrwbGKjtWXY7WNSxf76K6onf1Z-ZYaATYAIY7Wb87_3v4n9hMk6ody</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Lee, Kit-fai</creator><creator>Chong, Charing</creator><creator>Cheung, Sunny</creator><creator>Wong, John</creator><creator>Fung, Andrew</creator><creator>Lok, Hon-ting</creator><creator>Lo, Eugene</creator><creator>Lai, Paul</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0637-0291</orcidid></search><sort><creationdate>20210501</creationdate><title>Robotic versus open hemihepatectomy: a propensity score-matched study</title><author>Lee, Kit-fai ; Chong, Charing ; Cheung, Sunny ; Wong, John ; Fung, Andrew ; Lok, Hon-ting ; Lo, Eugene ; Lai, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-3ba5ca20316a669dab55208d81c03dc6081cdcff79808560db0525eb6d6bde13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Dissection</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatectomy</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Laparoscopy</topic><topic>Liver</topic><topic>Liver cancer</topic><topic>Liver cirrhosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Proctology</topic><topic>Robotics</topic><topic>Robots</topic><topic>Surgery</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Kit-fai</creatorcontrib><creatorcontrib>Chong, Charing</creatorcontrib><creatorcontrib>Cheung, Sunny</creatorcontrib><creatorcontrib>Wong, John</creatorcontrib><creatorcontrib>Fung, Andrew</creatorcontrib><creatorcontrib>Lok, Hon-ting</creatorcontrib><creatorcontrib>Lo, Eugene</creatorcontrib><creatorcontrib>Lai, Paul</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Kit-fai</au><au>Chong, Charing</au><au>Cheung, Sunny</au><au>Wong, John</au><au>Fung, Andrew</au><au>Lok, Hon-ting</au><au>Lo, Eugene</au><au>Lai, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic versus open hemihepatectomy: a propensity score-matched study</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>35</volume><issue>5</issue><spage>2316</spage><epage>2323</epage><pages>2316-2323</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.
Methods
Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio.
Results
After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min,
P
< 0.001) but the postoperative hospital stay was significantly shorter (median 5 days vs 6.5 days,
P
= 0.040) in the robotic group. When right and left hepatectomy were analyzed separately, the advantage of shorter hospital stay remained in left but not right hepatectomy. For patients with hepatocellular carcinoma, there was no difference between the two groups in 5-year overall and disease-free survival.
Conclusion
Compared with the open approach, robotic hemihepatectomy has longer operation time but shorter hospital stay. Thus, use of robot is feasible and effective in hemihepatectomy with the benefit of shorter hospital stay.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>33185767</pmid><doi>10.1007/s00464-020-07645-x</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-0637-0291</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Abdomen Abdominal Surgery Dissection Endoscopy Gastroenterology Gynecology Hepatectomy Hepatology Hospitals Laparoscopy Liver Liver cancer Liver cirrhosis Medicine Medicine & Public Health Patients Proctology Robotics Robots Surgery Veins & arteries |
| title | Robotic versus open hemihepatectomy: a propensity score-matched study |
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