Robotic versus laparoscopic resections of posterosuperior segments of the liver: a propensity score-matched comparison

被引:102
作者
Montalti, Roberto [1 ,3 ]
Scuderi, Vincenzo [3 ]
Patriti, Alberto [2 ]
Vivarelli, Marco [1 ]
Troisi, Roberto I. [3 ]
机构
[1] Ospedali Riuniti Ancona, Dept Gastroenterol & Transplantat Surg, Ancona, Italy
[2] Gen Hosp Spoleto, Div Gen Minimally Invas & Robot Surg, Spoleto, Italy
[3] Ghent Univ Hosp, Sch Med, Dept Gen & Hepatobiliary Surg, Liver Transplantat Serv, Pintelaan 185,2K12 IC, B-9000 Ghent, Belgium
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2016年 / 30卷 / 03期
关键词
Robotic liver resections; Laparoscopic liver resections; Posterosuperior segments; Propensity score; HEPATOCELLULAR-CARCINOMA; HEPATIC RESECTION; SURGERY; HEPATECTOMY; FEASIBILITY; METASTASES; TUMORS; ULTRASONOGRAPHY; EXPERIENCE; OUTCOMES;
D O I
10.1007/s00464-015-4284-9
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Open parenchymal-preserving resection is the current standard of care for lesions in the posterosuperior liver segments. Laparoscopy and robot-assisted surgery are emergent surgical approaches for liver resections, even in posteriorly located lesions. The objective of this study was to compare robot-assisted to laparoscopic parenchymal-preserving liver resections for lesions located in segments 7, 8, 4a, and 1. Methods Demographics, comorbidities, clinicopathologic characteristics, surgical treatments, and outcomes from patients who underwent laparoscopic and robot-assisted liver resection in two centers for lesions in the posterosuperior segments between June 2008 and February 2014 were reviewed. A 1: 2 matched propensity score analysis was performed by individually matching patients in the robotic cohort to patients in the laparoscopic cohort based on demographics, comorbidities, performance status, tumor stage, location, and type of resection. Results Thirty-six patients who underwent robot-assisted liver resection were matched with 72 patients undergoing laparoscopic liver resection. Matched patients displayed no significant differences in postoperative outcomes as measured by blood loss, hospital stay, R0 negative margin rate, and mortality. The overall morbidity according to the comprehensive complication index was also similar (34.6 +/- 33 vs. 18.4 +/- 11.3, respectively, for robotic and laparoscopic approach, p = 0.11). Patients undergoing robotic liver surgery had significantly longer inflow occlusion time (77 vs. 25 min, p = 0.001) as compared with their laparoscopic counterparts. Conclusions Although number and severity of complications in the robotic group appears to be higher, robotic and laparoscopic parenchymal-preserving liver resections in the posterosuperior segments display similar safety and feasibility.
引用
收藏
页码:1004 / 1013
页数:10
相关论文
共 51 条
[1]   Short- and medium-term results of totally laparoscopic resection for colorectal liver metastases [J].
Abu Hilal, M. ;
Underwood, T. ;
Zuccaro, M. ;
Primrose, J. ;
Pearce, N. .
BRITISH JOURNAL OF SURGERY, 2010, 97 (06) :927-933
[2]  
[Anonymous], 2012, ARXIV
[3]   Robot-assisted laparoscopic surgery of the colon and rectum [J].
Antoniou, Stavros A. ;
Antoniou, George A. ;
Koch, Oliver O. ;
Pointner, Rudolf ;
Granderath, Frank A. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2012, 26 (01) :1-11
[4]   Intraoperative Ultrasonography of Laparoscopic Hepatectomy: Key Technique for Safe Liver Transection [J].
Araki, Kenichiro ;
Conrad, Claudius ;
Ogiso, Satoshi ;
Kuwano, Hiroyuki ;
Gayet, Brice .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2014, 218 (02) :E37-E41
[5]   Robotic-assisted laparoscopic surgery: recent advances in urology [J].
Autorino, Riccardo ;
Zargar, Homayoun ;
Kaouk, Jihad H. .
FERTILITY AND STERILITY, 2014, 102 (04) :939-949
[6]   Robotic versus laparoscopic resection of liver tumours [J].
Berber, Eren ;
Akyildiz, Hizir Yakup ;
Aucejo, Federico ;
Gunasekaran, Ganesh ;
Chalikonda, Sricharan ;
Fung, John .
HPB, 2010, 12 (08) :583-586
[7]   The International Position on Laparoscopic Liver Surgery The Louisville Statement, 2008 [J].
Buell, Joseph F. ;
Cherqui, Daniel ;
Geller, David A. ;
O'Rourke, Nicholas ;
Iannitti, David ;
Dagher, Ibrahim ;
Koffron, Alan J. ;
Thomas, Mark ;
Gayet, Brice ;
Han, Ho Seong ;
Wakabayashi, Go ;
Belli, Giulio ;
Kaneko, Hironori ;
Ker, Chen-Guo ;
Scatton, Olivier ;
Laurent, Alexis ;
Abdalla, Eddie K. ;
Chaudhury, Prosanto ;
Dutson, Erik ;
Gamblin, Clark ;
D'Angelica, Michael ;
Nagorney, David ;
Testa, Giuliano ;
Labow, Daniel ;
Manas, Derrik ;
Poon, Ronnie T. ;
Nelson, Heidi ;
Martin, Robert ;
Clary, Bryan ;
Pinson, Wright C. ;
Martinie, John ;
Vauthey, Jean-Nicolas ;
Goldstein, Robert ;
Roayaie, Sasan ;
Barlet, David ;
Espat, Joseph ;
Abecassis, Michael ;
Rees, Myrddin ;
Fong, Yuman ;
McMasters, Kelly M. ;
Broelsch, Christoph ;
Busuttil, Ron ;
Belghiti, Jacques ;
Strasberg, Steven ;
Chari, Ravi S. .
ANNALS OF SURGERY, 2009, 250 (05) :825-830
[8]   A modified umbilical incision for specimen extraction after laparoscopic abdominal surgery [J].
Casciola, L. ;
Codacci-Pisanelli, M. ;
Ceccarelli, G. ;
Bartoli, A. ;
Di Zitti, L. ;
Patriti, A. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2008, 22 (03) :784-786
[9]   Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments [J].
Casciola, Luciano ;
Patriti, Alberto ;
Ceccarelli, Graziano ;
Bartoli, Alberto ;
Ceribelli, Cecilia ;
Spaziani, Alessandro .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2011, 25 (12) :3815-3824
[10]   Laparoscopic liver resections:: A feasibility study in 30 patients [J].
Cherqui, D ;
Husson, E ;
Hammoud, R ;
Malassagne, B ;
Stéphan, F ;
Bensaid, S ;
Rotman, N ;
Fagniez, PL .
ANNALS OF SURGERY, 2000, 232 (06) :753-761