Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison

Chen, Po-Da; Wu, Chunxiao; Hu, Rey‐Heng; Chou, Wei-Han; Lai, Hong‐Shiee; Liang, Jin–Tung; Lee, Po‐Huang; Wu, Yao‐Ming

doi:10.1245/s10434-016-5638-9

Cited by 119 publications

(105 citation statements)

References 29 publications

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“…The conversion (6%) and mortality rate (8%) are comparable to laparoscopic groups, also in case of HCC, where the robotic approach confirmed a good adequacy of the resection margin providing a disease-free and overall survival similar to other surgical approaches [30].…”

Section: Discussionsupporting

confidence: 53%

Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

Marino¹,

Shabat²,

Guarrasi³

et al. 2018

Dig Surg

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Background: Despite potential benefits of robotic liver surgery, it is still considered a “development in progress” technique. Methods: The outcomes of 14 patients undergoing robotic right hepatectomy were analyzed and compared with the results of 20 laparoscopic right hepatectomies consecutively performed by the same young surgeon. Results: The overall mean operative time was less in robotic arm (425 ± 139 vs. 565.18 ± 183.73, p = 0.022) and the estimated blood loss was similar (335.15 ± 139.8 vs. 423.95 ± 205.15, p = 0.17); no blood transfusion was required. Two patients in robotic group and 5 in laparoscopic group (p = 0.454) underwent conversion to open surgery; the overall morbidity was 21.4 and 15% in studied arms, respectively (p = 0.634). Pathology reports showed a mean surgical margin of 26.02 ± 3.9 in robotic arm, 28.76 ± 4.6 for laparoscopic, (p = 0.079) and we achieved a R0 resection rate of 91.66 and 85%, respectively. Reoperation and 90-days mortality rate were both null in robotic arm. One patient in laparoscopic group was reoperated due to postoperative hemorrhage. One-year overall and disease free-survival rate were 92.3 and 84.6%, respectively in robotic arm and 90 and 85% in laparoscopic arm. Conclusions: Robotic right hepatectomy is a safe and feasible technique providing promising short-term outcomes and oncological results also in the initial phase of learning curve.

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Section: Discussionsupporting

confidence: 53%

Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

Marino¹,

Shabat²,

Guarrasi³

et al. 2018

Dig Surg

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“…These data are in consistency with other results concerning standard laparoscopic surgery and globally compare favorably with that associated with conventional surgery.…”

Section: Discussionsupporting

confidence: 91%

“…Indeed, some of the well‐known advantages offered by the robotic platforms, such as increased surgical dexterity, magnified and three‐dimensional intraoperative view have proved to be a valuable help in facilitating and broadening the application of minimally invasive method for liver surgery . The last decade has seen robotic liver surgery gaining increasing acceptance worldwide, and a number of reports have been published in support of its safety and effectiveness . Nonetheless, only poor data are currently available on the oncological outcomes of liver malignancies excised by robotic surgery .…”

Section: Introductionmentioning

confidence: 99%

Surgical and oncological outcomes after ultrasound‐guided robotic liver resections for malignant tumor. Analysis of a prospective database

Pesi

Moraldi

Guerra

et al. 2019

Robotics Computer Surgery

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Aim Robotic surgery is thought to have a role in widening the application of minimally invasive liver surgery. Nonetheless, data concerning surgical results for liver malignancies are presently still lacking. We aimed to evaluate the surgical and oncological outcomes of ultrasound guided robotic liver resections for hepatic malignancies. Methods All consecutive patients who received robotic resection of primary and secondary liver malignancies from September 2008 to January 2017 were analyzed. The same surgical team performed all procedures following the principle of parenchymal‐sparing surgery. Results From a total of 51 patients, 13 patients (25%) underwent major and 38 (75%) minor hepatectomy. No mortality occurred. Two procedures were converted to open surgery. Five patients experienced major complications, with a reintervention rate of 6%. Median hospital stay was 5 days. Conclusions Robotic surgery is a safe and feasible procedure for liver resection even when dealing with malignancies. Our data show that robotic surgery can be considered a valid option to treat patients with liver malignancies in a minimally invasive manner, without compromise the oncological results.

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“…The pure laparoscopic techniques were reported in 85% LLS, 9.5% left lobes, and 5.5% right lobes (R.I. Troisi, personal communication, 2nd ICCLLS, Morioka 2014). From this, we note that the pure laparoscopic techniques have been essentially reserved for LLS grafts and for pediatric LDLT …”

Section: Discussionmentioning

confidence: 99%

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

et al. 2018

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Left lateral sectionectomy for donor hepatectomy is a well-established alternative to deceased donor pediatric liver transplantation. However, very little is available on the laparoscopic approach (laparoscopic left lateral sectionectomy [L-LLS]). With the aim to assess safety, reproducibility under proctorship, and outcomes following living donor liver transplantation in children, a comparative single-center series using propensity score matching (PSM) to evaluate open left lateral sectionectomy (O-LLS) versus L-LLS was carried out in a relatively short time period in a high-volume pediatric transplant center. A retrospective, observational, single-center, PSM study was conducted on 220 consecutive living donor hepatectomies from January 2011 to April 2017. The variables considered for PSM were as follows: year of operation, recipient age, indication for transplant, recipient weight, donor sex, donor age, and donor body mass index. After matching, 72 O-LLSs were fit to be compared with 72 L-LLSs. Operative time and warm ischemia time were significantly longer in L-LLSs, whereas blood loss and overall donor complication rates were significantly lower. Postoperative day 1 and 4 pain scores were significantly less in the L-LLS group (P = 0.015 and 0.003, respectively). The length of hospital stay was significantly shorter in L-LLS (4.6 versus 4.1 days; P = 0.014). Overall donor biliary complications were 9 (12.5%) and 1 (1.4%) for O-LLS and L-LLS (P = 0.022), respectively. Vascular complications occurred in 3 (4.2%) children without graft loss in the laparoscopic group. The 1-, 3-, and 5-year overall patient survival rates were 98.5%, 90.9%, and 90.9% in the O-LLS group and in the L-LLS group 94.3%, 92.7%, and 86.8% (P = 0.28). In conclusion, L-LLS for donor hepatectomy is a safe and reproducible technique yielding better donor perioperative outcomes with respect to the conventional approach with similar recipient outcomes.

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Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison

Cited by 119 publications

References 29 publications

Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

Comparative Study of the Initial Experience in Performing Robotic and Laparoscopic Right Hepatectomy with Technical Description of the Robotic Technique

Surgical and oncological outcomes after ultrasound‐guided robotic liver resections for malignant tumor. Analysis of a prospective database

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

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