Robotic-assisted versus laparoscopic major liver resection: analysis of outcomes from a single center

Fruscione, Mike; Pickens, R.C.; Baker, E.; Cochran, Allyson; Khan, Adeel; Ocuin, Lee M.; Iannitti, David A.; Vrochides, Dionisios; Martinie, John B.

doi:10.1016/j.hpb.2018.11.011

Cited by 90 publications

(96 citation statements)

References 21 publications

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“…However, some previous studies showed that the blood loss in patients who underwent major hepatectomy via robotic vs laparoscopic approaches was non‐significantly different. Spampinato et al and Fruscione et al reported that the estimated blood loss in robotic and laparoscopic major hepatectomies were 250 and 400 mL ( P > .05), respectively. Similarly, Tsung et al reported that the estimated blood loss in robotic and laparoscopic major hepatectomies was 200 and 300 mL ( P = .527), respectively.…”

Section: Discussionmentioning

confidence: 97%

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Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Wang

Tang

et al. 2019

Journal of Surgical Oncology

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Background: Robotic surgery is increasingly being used in hepatectomy. Previous studies comparing the robotic and laparoscopic minor hepatectomy have been documented, but comparative studies on robotic and laparoscopic hemihepatectomy (LH) involving a large patient cohort are rare. The objective of this study was to compare perioperative outcomes between robotic and LH.Methods: Data on the demographics, clinicopathologic characteristics, and perioperative outcomes of consecutive patients who underwent robotic or LH in a single center between November 2011 and July 2017 were analyzed.Results: A total of 92 patients underwent robotic and 48 LH. Multiple linear regression analysis showed no significant difference in perioperative outcomes including operative time, postoperative hospital stay, postoperative complications, and mortality between the groups. Compared to the laparoscopic cohort, the robotic cohort had a significantly less estimated blood loss (120.24 mL; 95% confidence interval, 53.72-186.76) and a significantly lower conversation rate (1.09% vs 10.42%; P = .034). Stratified and interaction analyses demonstrated that disease type had an interaction effect on the association between the operative approach and the estimated blood loss.Conclusions: Robotic hemihepatectomy was safe and feasible in selected patients.It had similar perioperative outcomes as LH and was better than LH regarding estimated blood loss and open conversion.

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Section: Discussionmentioning

confidence: 97%

“…In previous studies on minor hepatectomy and liver resection for posterior liver segments, robotic surgery showed similar perioperative outcomes compared to laparoscopic surgery . However, studies on a large cohort of patients for robotic hemihepatectomy (RH) vs laparoscopic hemihepatectomy (LH) from a single center are rare …”

Section: Introductionmentioning

confidence: 99%

Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Wang

Tang

et al. 2019

Journal of Surgical Oncology

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“…Robot-assisted surgery has been increasingly employed as an alternative to laparoscopy for MILR, mainly in complex and major liver resections [ 29 , 30 ]. Despite potential advantages, most of the available evidence demonstrated similar results between laparoscopic and robotic liver resections [ 5 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

et al. 2020

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Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs) Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, overall morbidity or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe in experienced hands. Minimally invasive approach was associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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“…Robot-assisted surgery has been increasingly employed as an alternative to laparoscopy for MILR, mainly in complex and major liver resections (27,28). Despite potential advantages, most of the available evidence demonstrated similar results between laparoscopic and robotic liver resections (5,29,30).…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

Duarte

Coelho

Valverde

et al. 2020

Preprint

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Abstract Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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Robotic-assisted versus laparoscopic major liver resection: analysis of outcomes from a single center

Cited by 90 publications

References 21 publications

Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Robotic vs laparoscopic hemihepatectomy: A comparative study from a single center

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

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