Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience
Background The advantages of the robotic approach in minimally invasive liver surgery (MILS) are still debated. This study compares the short-term outcomes between laparoscopic (LLR) and robotic (RLR) liver resections in propensity score matched cohorts. Methods Data regarding minimally invasive liv...
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| Veröffentlicht in: | Surgical endoscopy 2023-10, Vol.37 (10), p.8123-8132 |
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| creator | Balzano, Emanuele Bernardi, Lorenzo Roesel, Raffaello Vagelli, Filippo Ghinolfi, Davide Tincani, Giovanni Catalano, Gabriele Melandro, Fabio Petrusic, Antonietta Popeskou, Sotirios-Georgios Christoforidis, Dimitri Majno-Hurst, Pietro De Simone, Paolo Cristaudi, Alessandra |
| description | Background
The advantages of the robotic approach in minimally invasive liver surgery (MILS) are still debated. This study compares the short-term outcomes between laparoscopic (LLR) and robotic (RLR) liver resections in propensity score matched cohorts.
Methods
Data regarding minimally invasive liver resections in two liver surgery units were retrospectively reviewed. A propensity score matched analysis (1:1 ratio) identified two groups of patients with similar characteristics. Intra- and post-operative outcomes were then compared. The difficulty of MILS was based on the IWATE criteria.
Results
Two hundred sixty-nine patients underwent MILS between January 2014 and December 2021 (LLR = 192; RLR = 77). Propensity score matching identified 148 cases (LLR = 74; RLR = 74) consisting of compensated cirrhotic patients (100%) underwent non-anatomic resection of IWATE 1–2 class (90.5%) for a solitary tumor 0.999) were similar, without post-operative mortality. Hospital stay was shorter in the robotic group (6.2 vs. 6.6,
p
= 0.0001).
Conclusion
This study supports the non-inferiority of RLR over LLR. In compensated cirrhotic patients underwent resection of low-to-intermediate difficulty for a solitary nodule |
| doi_str_mv | 10.1007/s00464-023-10358-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2866112328</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2868475722</sourcerecordid><originalsourceid>FETCH-LOGICAL-c352t-daaea3c8a38ad3a73ca4e93d9d3edcc56f306e29857e290fcc414dd54c7708f53</originalsourceid><addsrcrecordid>eNp9kE1LxDAQQIMouK7-AU8FL16i-WqbepPFL1gQRM8hTqbapdvUpFX335u1guDBSwLDe8PwCDnm7IwzVp5HxlShKBOSciZzTYsdMuNKCioE17tkxirJqCgrtU8OYlyxxFc8nxH34J_90ED2jiGOMWttb4OP4Ps0a5s0zQJGhKHxXbzI-uB77GIzbOjaDvCKLgO_TkoTfZf5Ohs-PAXshuThZ4-hwQ7wkOzVto149PPPydP11ePili7vb-4Wl0sKMhcDddailaCt1NZJW0qwCivpKifRAeRFLVmBotJ5mV5WAyiunMsVlCXTdS7n5HTam858GzEOZt1EwLa1HfoxGqGLgnMhhU7oyR905cfQpeu2lFZlXgqRKDFRkJrEgLXpQ7O2YWM4M9vwZgpvUnjzHd4USZKTFBPcvWD4Xf2P9QXCdIiA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2868475722</pqid></control><display><type>article</type><title>Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience</title><source>SpringerLink Journals</source><creator>Balzano, Emanuele ; Bernardi, Lorenzo ; Roesel, Raffaello ; Vagelli, Filippo ; Ghinolfi, Davide ; Tincani, Giovanni ; Catalano, Gabriele ; Melandro, Fabio ; Petrusic, Antonietta ; Popeskou, Sotirios-Georgios ; Christoforidis, Dimitri ; Majno-Hurst, Pietro ; De Simone, Paolo ; Cristaudi, Alessandra</creator><creatorcontrib>Balzano, Emanuele ; Bernardi, Lorenzo ; Roesel, Raffaello ; Vagelli, Filippo ; Ghinolfi, Davide ; Tincani, Giovanni ; Catalano, Gabriele ; Melandro, Fabio ; Petrusic, Antonietta ; Popeskou, Sotirios-Georgios ; Christoforidis, Dimitri ; Majno-Hurst, Pietro ; De Simone, Paolo ; Cristaudi, Alessandra</creatorcontrib><description>Background
The advantages of the robotic approach in minimally invasive liver surgery (MILS) are still debated. This study compares the short-term outcomes between laparoscopic (LLR) and robotic (RLR) liver resections in propensity score matched cohorts.
Methods
Data regarding minimally invasive liver resections in two liver surgery units were retrospectively reviewed. A propensity score matched analysis (1:1 ratio) identified two groups of patients with similar characteristics. Intra- and post-operative outcomes were then compared. The difficulty of MILS was based on the IWATE criteria.
Results
Two hundred sixty-nine patients underwent MILS between January 2014 and December 2021 (LLR = 192; RLR = 77). Propensity score matching identified 148 cases (LLR = 74; RLR = 74) consisting of compensated cirrhotic patients (100%) underwent non-anatomic resection of IWATE 1–2 class (90.5%) for a solitary tumor < 5 cm in diameter (93.2%). In such patients, RLRs had shorter operative time (227 vs. 250 min,
p
= 0.002), shorter Pringle’s cumulative time (12 vs. 28 min,
p
< 0.0001), and less blood loss (137 vs. 209 cc,
p
= 0.006) vs. LLRs. Conversion rate was nihil (both groups). In RLRs compared to LLRs, R0 rate (93 vs. 96%,
p
> 0.71) and major morbidity (4.1 vs. 5.4%,
p
> 0.999) were similar, without post-operative mortality. Hospital stay was shorter in the robotic group (6.2 vs. 6.6,
p
= 0.0001).
Conclusion
This study supports the non-inferiority of RLR over LLR. In compensated cirrhotic patients underwent resection of low-to-intermediate difficulty for a solitary nodule < 5 cm, RLR was faster, with less blood loss despite the shorter hilar clamping, and required shorter hospitalization compared to LLR.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-023-10358-6</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>2023 EAES Oral ; Abdominal Surgery ; Contraindications ; Endoscopy ; Gastroenterology ; Gynecology ; Hepatology ; Hospitals ; Laparoscopy ; Liver cirrhosis ; Liver transplants ; Medicine ; Medicine & Public Health ; Patients ; Proctology ; Robotic surgery ; Surgeons ; Surgery</subject><ispartof>Surgical endoscopy, 2023-10, Vol.37 (10), p.8123-8132</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-daaea3c8a38ad3a73ca4e93d9d3edcc56f306e29857e290fcc414dd54c7708f53</citedby><cites>FETCH-LOGICAL-c352t-daaea3c8a38ad3a73ca4e93d9d3edcc56f306e29857e290fcc414dd54c7708f53</cites><orcidid>0000-0002-0272-7559</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/s00464-023-10358-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-023-10358-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Balzano, Emanuele</creatorcontrib><creatorcontrib>Bernardi, Lorenzo</creatorcontrib><creatorcontrib>Roesel, Raffaello</creatorcontrib><creatorcontrib>Vagelli, Filippo</creatorcontrib><creatorcontrib>Ghinolfi, Davide</creatorcontrib><creatorcontrib>Tincani, Giovanni</creatorcontrib><creatorcontrib>Catalano, Gabriele</creatorcontrib><creatorcontrib>Melandro, Fabio</creatorcontrib><creatorcontrib>Petrusic, Antonietta</creatorcontrib><creatorcontrib>Popeskou, Sotirios-Georgios</creatorcontrib><creatorcontrib>Christoforidis, Dimitri</creatorcontrib><creatorcontrib>Majno-Hurst, Pietro</creatorcontrib><creatorcontrib>De Simone, Paolo</creatorcontrib><creatorcontrib>Cristaudi, Alessandra</creatorcontrib><title>Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><description>Background
The advantages of the robotic approach in minimally invasive liver surgery (MILS) are still debated. This study compares the short-term outcomes between laparoscopic (LLR) and robotic (RLR) liver resections in propensity score matched cohorts.
Methods
Data regarding minimally invasive liver resections in two liver surgery units were retrospectively reviewed. A propensity score matched analysis (1:1 ratio) identified two groups of patients with similar characteristics. Intra- and post-operative outcomes were then compared. The difficulty of MILS was based on the IWATE criteria.
Results
Two hundred sixty-nine patients underwent MILS between January 2014 and December 2021 (LLR = 192; RLR = 77). Propensity score matching identified 148 cases (LLR = 74; RLR = 74) consisting of compensated cirrhotic patients (100%) underwent non-anatomic resection of IWATE 1–2 class (90.5%) for a solitary tumor < 5 cm in diameter (93.2%). In such patients, RLRs had shorter operative time (227 vs. 250 min,
p
= 0.002), shorter Pringle’s cumulative time (12 vs. 28 min,
p
< 0.0001), and less blood loss (137 vs. 209 cc,
p
= 0.006) vs. LLRs. Conversion rate was nihil (both groups). In RLRs compared to LLRs, R0 rate (93 vs. 96%,
p
> 0.71) and major morbidity (4.1 vs. 5.4%,
p
> 0.999) were similar, without post-operative mortality. Hospital stay was shorter in the robotic group (6.2 vs. 6.6,
p
= 0.0001).
Conclusion
This study supports the non-inferiority of RLR over LLR. In compensated cirrhotic patients underwent resection of low-to-intermediate difficulty for a solitary nodule < 5 cm, RLR was faster, with less blood loss despite the shorter hilar clamping, and required shorter hospitalization compared to LLR.</description><subject>2023 EAES Oral</subject><subject>Abdominal Surgery</subject><subject>Contraindications</subject><subject>Endoscopy</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Laparoscopy</subject><subject>Liver cirrhosis</subject><subject>Liver transplants</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Proctology</subject><subject>Robotic surgery</subject><subject>Surgeons</subject><subject>Surgery</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kE1LxDAQQIMouK7-AU8FL16i-WqbepPFL1gQRM8hTqbapdvUpFX335u1guDBSwLDe8PwCDnm7IwzVp5HxlShKBOSciZzTYsdMuNKCioE17tkxirJqCgrtU8OYlyxxFc8nxH34J_90ED2jiGOMWttb4OP4Ps0a5s0zQJGhKHxXbzI-uB77GIzbOjaDvCKLgO_TkoTfZf5Ohs-PAXshuThZ4-hwQ7wkOzVto149PPPydP11ePili7vb-4Wl0sKMhcDddailaCt1NZJW0qwCivpKifRAeRFLVmBotJ5mV5WAyiunMsVlCXTdS7n5HTam858GzEOZt1EwLa1HfoxGqGLgnMhhU7oyR905cfQpeu2lFZlXgqRKDFRkJrEgLXpQ7O2YWM4M9vwZgpvUnjzHd4USZKTFBPcvWD4Xf2P9QXCdIiA</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Balzano, Emanuele</creator><creator>Bernardi, Lorenzo</creator><creator>Roesel, Raffaello</creator><creator>Vagelli, Filippo</creator><creator>Ghinolfi, Davide</creator><creator>Tincani, Giovanni</creator><creator>Catalano, Gabriele</creator><creator>Melandro, Fabio</creator><creator>Petrusic, Antonietta</creator><creator>Popeskou, Sotirios-Georgios</creator><creator>Christoforidis, Dimitri</creator><creator>Majno-Hurst, Pietro</creator><creator>De Simone, Paolo</creator><creator>Cristaudi, Alessandra</creator><general>Springer US</general><general>Springer Nature B.V</general><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>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0272-7559</orcidid></search><sort><creationdate>20231001</creationdate><title>Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience</title><author>Balzano, Emanuele ; Bernardi, Lorenzo ; Roesel, Raffaello ; Vagelli, Filippo ; Ghinolfi, Davide ; Tincani, Giovanni ; Catalano, Gabriele ; Melandro, Fabio ; Petrusic, Antonietta ; Popeskou, Sotirios-Georgios ; Christoforidis, Dimitri ; Majno-Hurst, Pietro ; De Simone, Paolo ; Cristaudi, Alessandra</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-daaea3c8a38ad3a73ca4e93d9d3edcc56f306e29857e290fcc414dd54c7708f53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>2023 EAES Oral</topic><topic>Abdominal Surgery</topic><topic>Contraindications</topic><topic>Endoscopy</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Laparoscopy</topic><topic>Liver cirrhosis</topic><topic>Liver transplants</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Proctology</topic><topic>Robotic surgery</topic><topic>Surgeons</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Balzano, Emanuele</creatorcontrib><creatorcontrib>Bernardi, Lorenzo</creatorcontrib><creatorcontrib>Roesel, Raffaello</creatorcontrib><creatorcontrib>Vagelli, Filippo</creatorcontrib><creatorcontrib>Ghinolfi, Davide</creatorcontrib><creatorcontrib>Tincani, Giovanni</creatorcontrib><creatorcontrib>Catalano, Gabriele</creatorcontrib><creatorcontrib>Melandro, Fabio</creatorcontrib><creatorcontrib>Petrusic, Antonietta</creatorcontrib><creatorcontrib>Popeskou, Sotirios-Georgios</creatorcontrib><creatorcontrib>Christoforidis, Dimitri</creatorcontrib><creatorcontrib>Majno-Hurst, Pietro</creatorcontrib><creatorcontrib>De Simone, Paolo</creatorcontrib><creatorcontrib>Cristaudi, Alessandra</creatorcontrib><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 Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Balzano, Emanuele</au><au>Bernardi, Lorenzo</au><au>Roesel, Raffaello</au><au>Vagelli, Filippo</au><au>Ghinolfi, Davide</au><au>Tincani, Giovanni</au><au>Catalano, Gabriele</au><au>Melandro, Fabio</au><au>Petrusic, Antonietta</au><au>Popeskou, Sotirios-Georgios</au><au>Christoforidis, Dimitri</au><au>Majno-Hurst, Pietro</au><au>De Simone, Paolo</au><au>Cristaudi, Alessandra</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><date>2023-10-01</date><risdate>2023</risdate><volume>37</volume><issue>10</issue><spage>8123</spage><epage>8132</epage><pages>8123-8132</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
The advantages of the robotic approach in minimally invasive liver surgery (MILS) are still debated. This study compares the short-term outcomes between laparoscopic (LLR) and robotic (RLR) liver resections in propensity score matched cohorts.
Methods
Data regarding minimally invasive liver resections in two liver surgery units were retrospectively reviewed. A propensity score matched analysis (1:1 ratio) identified two groups of patients with similar characteristics. Intra- and post-operative outcomes were then compared. The difficulty of MILS was based on the IWATE criteria.
Results
Two hundred sixty-nine patients underwent MILS between January 2014 and December 2021 (LLR = 192; RLR = 77). Propensity score matching identified 148 cases (LLR = 74; RLR = 74) consisting of compensated cirrhotic patients (100%) underwent non-anatomic resection of IWATE 1–2 class (90.5%) for a solitary tumor < 5 cm in diameter (93.2%). In such patients, RLRs had shorter operative time (227 vs. 250 min,
p
= 0.002), shorter Pringle’s cumulative time (12 vs. 28 min,
p
< 0.0001), and less blood loss (137 vs. 209 cc,
p
= 0.006) vs. LLRs. Conversion rate was nihil (both groups). In RLRs compared to LLRs, R0 rate (93 vs. 96%,
p
> 0.71) and major morbidity (4.1 vs. 5.4%,
p
> 0.999) were similar, without post-operative mortality. Hospital stay was shorter in the robotic group (6.2 vs. 6.6,
p
= 0.0001).
Conclusion
This study supports the non-inferiority of RLR over LLR. In compensated cirrhotic patients underwent resection of low-to-intermediate difficulty for a solitary nodule < 5 cm, RLR was faster, with less blood loss despite the shorter hilar clamping, and required shorter hospitalization compared to LLR.</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s00464-023-10358-6</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0272-7559</orcidid></addata></record> |
| fulltext | fulltext |
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| ispartof | Surgical endoscopy, 2023-10, Vol.37 (10), p.8123-8132 |
| issn | 0930-2794 1432-2218 |
| language | eng |
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| source | SpringerLink Journals |
| subjects | 2023 EAES Oral Abdominal Surgery Contraindications Endoscopy Gastroenterology Gynecology Hepatology Hospitals Laparoscopy Liver cirrhosis Liver transplants Medicine Medicine & Public Health Patients Proctology Robotic surgery Surgeons Surgery |
| title | Robotic versus laparoscopic liver resections: propensity-matched comparison of two-center experience |
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