Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma
Postoperative complications are vital factors affecting the prognosis of patients with hepatocellular carcinoma (HCC), especially for complex hepatectomy. The present study aimed to compare perioperative complications between laparoscopic and robotic complex hepatectomy (LCH vs. RCH). Patients with...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2024-08, Vol.26 (8), p.1062-1071 |
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| creator | Huang, Xiao-Kun Lu, Wen-Feng Liu, Si-Yu Fu, Tian-Wei Jin, Lei Du, Cheng-Fei Gao, Zhen-Yu Wang, Kai-Di Dai, Mu-Gen Zhong, Zhi-Han Ye, Tai-Wei Xiao, Zun-Qiang Cheng, Jian Shen, Guo-Liang Liu, Jie Liu, Jun-Wei Huang, Dong-Sheng Liang, Lei Zhang, Cheng-Wu |
| description | Postoperative complications are vital factors affecting the prognosis of patients with hepatocellular carcinoma (HCC), especially for complex hepatectomy. The present study aimed to compare perioperative complications between laparoscopic and robotic complex hepatectomy (LCH vs. RCH).
Patients with solitary HCC after complex hepatectomy were collected from a multicenter database. Propensity score-matched (PSM) analysis was adopted to control confounding bias. Multivariable analysis was performed to determine the prognostic factors.
436 patients were included. After PSM, 43 patients were included in both the LCH and RCH groups. The results showed that compared to LCH, RCH had lower rates of blood loss and transfusion, and lower postoperative 30-day and major morbidity, and post-hepatectomy liver failure (PHLF) (all P < 0.05). Additionally, the length of hospital stay was shorter in the RCH group (P = 0.026). Multivariable analysis showed RCH is an independent protective factor for reducing the 30-day morbidity, major morbidity and PHLF.
RCH has advantages over LCH in the minimally invasive treatment of complex HCC, as it can reduce the incidence of postoperative morbidity. Therefore, RCH should be considered for patients with HCC who require complex hepatectomy. |
| doi_str_mv | 10.1016/j.hpb.2024.05.013 |
| format | Article |
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Patients with solitary HCC after complex hepatectomy were collected from a multicenter database. Propensity score-matched (PSM) analysis was adopted to control confounding bias. Multivariable analysis was performed to determine the prognostic factors.
436 patients were included. After PSM, 43 patients were included in both the LCH and RCH groups. The results showed that compared to LCH, RCH had lower rates of blood loss and transfusion, and lower postoperative 30-day and major morbidity, and post-hepatectomy liver failure (PHLF) (all P < 0.05). Additionally, the length of hospital stay was shorter in the RCH group (P = 0.026). Multivariable analysis showed RCH is an independent protective factor for reducing the 30-day morbidity, major morbidity and PHLF.
RCH has advantages over LCH in the minimally invasive treatment of complex HCC, as it can reduce the incidence of postoperative morbidity. Therefore, RCH should be considered for patients with HCC who require complex hepatectomy.</description><identifier>ISSN: 1365-182X</identifier><identifier>ISSN: 1477-2574</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1016/j.hpb.2024.05.013</identifier><identifier>PMID: 38830783</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Aged ; Carcinoma, Hepatocellular - surgery ; Databases, Factual ; Female ; Hepatectomy - adverse effects ; Hepatectomy - methods ; Humans ; Laparoscopy - adverse effects ; Length of Stay ; Liver Neoplasms - surgery ; Male ; Middle Aged ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Propensity Score ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Robotic Surgical Procedures - adverse effects ; Time Factors ; Treatment Outcome</subject><ispartof>HPB (Oxford, England), 2024-08, Vol.26 (8), p.1062-1071</ispartof><rights>2024 International Hepato-Pancreato-Biliary Association Inc.</rights><rights>Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c278t-51268ec75a2f40c4150bc88ae5603322271e202007078586c5a5eb881657a5563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38830783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Huang, Xiao-Kun</creatorcontrib><creatorcontrib>Lu, Wen-Feng</creatorcontrib><creatorcontrib>Liu, Si-Yu</creatorcontrib><creatorcontrib>Fu, Tian-Wei</creatorcontrib><creatorcontrib>Jin, Lei</creatorcontrib><creatorcontrib>Du, Cheng-Fei</creatorcontrib><creatorcontrib>Gao, Zhen-Yu</creatorcontrib><creatorcontrib>Wang, Kai-Di</creatorcontrib><creatorcontrib>Dai, Mu-Gen</creatorcontrib><creatorcontrib>Zhong, Zhi-Han</creatorcontrib><creatorcontrib>Ye, Tai-Wei</creatorcontrib><creatorcontrib>Xiao, Zun-Qiang</creatorcontrib><creatorcontrib>Cheng, Jian</creatorcontrib><creatorcontrib>Shen, Guo-Liang</creatorcontrib><creatorcontrib>Liu, Jie</creatorcontrib><creatorcontrib>Liu, Jun-Wei</creatorcontrib><creatorcontrib>Huang, Dong-Sheng</creatorcontrib><creatorcontrib>Liang, Lei</creatorcontrib><creatorcontrib>Zhang, Cheng-Wu</creatorcontrib><title>Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>Postoperative complications are vital factors affecting the prognosis of patients with hepatocellular carcinoma (HCC), especially for complex hepatectomy. The present study aimed to compare perioperative complications between laparoscopic and robotic complex hepatectomy (LCH vs. RCH).
Patients with solitary HCC after complex hepatectomy were collected from a multicenter database. Propensity score-matched (PSM) analysis was adopted to control confounding bias. Multivariable analysis was performed to determine the prognostic factors.
436 patients were included. After PSM, 43 patients were included in both the LCH and RCH groups. The results showed that compared to LCH, RCH had lower rates of blood loss and transfusion, and lower postoperative 30-day and major morbidity, and post-hepatectomy liver failure (PHLF) (all P < 0.05). Additionally, the length of hospital stay was shorter in the RCH group (P = 0.026). Multivariable analysis showed RCH is an independent protective factor for reducing the 30-day morbidity, major morbidity and PHLF.
RCH has advantages over LCH in the minimally invasive treatment of complex HCC, as it can reduce the incidence of postoperative morbidity. Therefore, RCH should be considered for patients with HCC who require complex hepatectomy.</description><subject>Adult</subject><subject>Aged</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Databases, Factual</subject><subject>Female</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - methods</subject><subject>Humans</subject><subject>Laparoscopy - adverse effects</subject><subject>Length of Stay</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1365-182X</issn><issn>1477-2574</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1TAURS0EoqXwAUyQh0wS_IgfFSNUlYdUxAQkZpbjnOj6KomD7VTcP-IzOeEWhoxs6ay97X02IS85aznj-s2xPax9K5joWqZaxuUjcsk7YxqhTPcY71Krhlvx_YI8K-XImEDZ9VNyIa2VzFh5SX593qYaAywVMl1zWmEpsZ5oCSlDM_saDjBQv_jpVGKhNdGQ5tVnoCvkiHj2Nd4DnVPu47Ar_bhbTR6hhC5rDDRlmlOf8J0_6gl-0gOsvkKoaT7REeclTbH6fDoPUoBp2iafafA5xCXN_jl5MvqpwIuH84p8e3_79eZjc_flw6ebd3dNEMbWRnGhLQSjvBg7FjquWB-s9aA0k1IIYTjgwhgzmF9ZHZRX0FvLtTJeKS2vyOuzLy7jxwalujmW_Tt-gbQVJ5nulGVGXyPKz2jApCXD6NYcZwzhOHN7Qe7osCC3F-SYclgQal492G_9DMM_xd9GEHh7BgBD3kfIroQIS4AhZtyXG1L8j_1vjPallg</recordid><startdate>202408</startdate><enddate>202408</enddate><creator>Huang, Xiao-Kun</creator><creator>Lu, Wen-Feng</creator><creator>Liu, Si-Yu</creator><creator>Fu, Tian-Wei</creator><creator>Jin, Lei</creator><creator>Du, Cheng-Fei</creator><creator>Gao, Zhen-Yu</creator><creator>Wang, Kai-Di</creator><creator>Dai, Mu-Gen</creator><creator>Zhong, Zhi-Han</creator><creator>Ye, Tai-Wei</creator><creator>Xiao, Zun-Qiang</creator><creator>Cheng, Jian</creator><creator>Shen, Guo-Liang</creator><creator>Liu, Jie</creator><creator>Liu, Jun-Wei</creator><creator>Huang, Dong-Sheng</creator><creator>Liang, Lei</creator><creator>Zhang, Cheng-Wu</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202408</creationdate><title>Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma</title><author>Huang, Xiao-Kun ; Lu, Wen-Feng ; Liu, Si-Yu ; Fu, Tian-Wei ; Jin, Lei ; Du, Cheng-Fei ; Gao, Zhen-Yu ; Wang, Kai-Di ; Dai, Mu-Gen ; Zhong, Zhi-Han ; Ye, Tai-Wei ; Xiao, Zun-Qiang ; Cheng, Jian ; Shen, Guo-Liang ; Liu, Jie ; Liu, Jun-Wei ; Huang, Dong-Sheng ; Liang, Lei ; Zhang, Cheng-Wu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c278t-51268ec75a2f40c4150bc88ae5603322271e202007078586c5a5eb881657a5563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Databases, Factual</topic><topic>Female</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - methods</topic><topic>Humans</topic><topic>Laparoscopy - adverse effects</topic><topic>Length of Stay</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Huang, Xiao-Kun</creatorcontrib><creatorcontrib>Lu, Wen-Feng</creatorcontrib><creatorcontrib>Liu, Si-Yu</creatorcontrib><creatorcontrib>Fu, Tian-Wei</creatorcontrib><creatorcontrib>Jin, Lei</creatorcontrib><creatorcontrib>Du, Cheng-Fei</creatorcontrib><creatorcontrib>Gao, Zhen-Yu</creatorcontrib><creatorcontrib>Wang, Kai-Di</creatorcontrib><creatorcontrib>Dai, Mu-Gen</creatorcontrib><creatorcontrib>Zhong, Zhi-Han</creatorcontrib><creatorcontrib>Ye, Tai-Wei</creatorcontrib><creatorcontrib>Xiao, Zun-Qiang</creatorcontrib><creatorcontrib>Cheng, Jian</creatorcontrib><creatorcontrib>Shen, Guo-Liang</creatorcontrib><creatorcontrib>Liu, Jie</creatorcontrib><creatorcontrib>Liu, Jun-Wei</creatorcontrib><creatorcontrib>Huang, Dong-Sheng</creatorcontrib><creatorcontrib>Liang, Lei</creatorcontrib><creatorcontrib>Zhang, Cheng-Wu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Huang, Xiao-Kun</au><au>Lu, Wen-Feng</au><au>Liu, Si-Yu</au><au>Fu, Tian-Wei</au><au>Jin, Lei</au><au>Du, Cheng-Fei</au><au>Gao, Zhen-Yu</au><au>Wang, Kai-Di</au><au>Dai, Mu-Gen</au><au>Zhong, Zhi-Han</au><au>Ye, Tai-Wei</au><au>Xiao, Zun-Qiang</au><au>Cheng, Jian</au><au>Shen, Guo-Liang</au><au>Liu, Jie</au><au>Liu, Jun-Wei</au><au>Huang, Dong-Sheng</au><au>Liang, Lei</au><au>Zhang, Cheng-Wu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2024-08</date><risdate>2024</risdate><volume>26</volume><issue>8</issue><spage>1062</spage><epage>1071</epage><pages>1062-1071</pages><issn>1365-182X</issn><issn>1477-2574</issn><eissn>1477-2574</eissn><abstract>Postoperative complications are vital factors affecting the prognosis of patients with hepatocellular carcinoma (HCC), especially for complex hepatectomy. The present study aimed to compare perioperative complications between laparoscopic and robotic complex hepatectomy (LCH vs. RCH).
Patients with solitary HCC after complex hepatectomy were collected from a multicenter database. Propensity score-matched (PSM) analysis was adopted to control confounding bias. Multivariable analysis was performed to determine the prognostic factors.
436 patients were included. After PSM, 43 patients were included in both the LCH and RCH groups. The results showed that compared to LCH, RCH had lower rates of blood loss and transfusion, and lower postoperative 30-day and major morbidity, and post-hepatectomy liver failure (PHLF) (all P < 0.05). Additionally, the length of hospital stay was shorter in the RCH group (P = 0.026). Multivariable analysis showed RCH is an independent protective factor for reducing the 30-day morbidity, major morbidity and PHLF.
RCH has advantages over LCH in the minimally invasive treatment of complex HCC, as it can reduce the incidence of postoperative morbidity. Therefore, RCH should be considered for patients with HCC who require complex hepatectomy.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>38830783</pmid><doi>10.1016/j.hpb.2024.05.013</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Carcinoma, Hepatocellular - surgery Databases, Factual Female Hepatectomy - adverse effects Hepatectomy - methods Humans Laparoscopy - adverse effects Length of Stay Liver Neoplasms - surgery Male Middle Aged Postoperative Complications - epidemiology Postoperative Complications - etiology Propensity Score Retrospective Studies Risk Assessment Risk Factors Robotic Surgical Procedures - adverse effects Time Factors Treatment Outcome |
| title | Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma |
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