Robotic versus open hemihepatectomy: a propensity score-matched study
- PDF / 586,435 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 261 Views
and Other Interventional Techniques
Robotic versus open hemihepatectomy: a propensity score‑matched study Kit‑fai Lee1 · Charing Chong1 · Sunny Cheung1 · John Wong1 · Andrew Fung1 · Hon‑ting Lok1 · Eugene Lo1 · Paul Lai1 Received: 4 December 2019 / Accepted: 13 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy. Methods Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio. Results After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min, P 0.999
0.07
0.00
0.02 − 0.48
35 (97.2%) 1 (2.8%) 21 (58.3%) 0 (0.0%)
> 0.999
0.903 0.047*
35 (97.2%) 1 (2.8%) 21 (58.3%) 0 (0.0%)
> 0.999 > 0.999
0.00 0.00
0.999 > 0.999 > 0.999 0.063 > 0.999 > 0.999 0.118 0.125 0.031* 0.238 0.429 0.625 0.999 > 0.999 0.302
3 (8.3%) 3 (8.3%) 7 (19.4%)
2 (5.6%) 3 (8.3%) 3 (8.3%)
> 0.999 > 0.999 0.344
0 (0.0%) 6 (16.7%) 2 (5.6%) 1 (2.8%) 1 (2.8%) 1 (2.8%) 1 (2.8%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 1 (2.8%) 2 (5.6%) 1 (2.8%) 1 (2.8%) 0 (0–1) 5 (3–22) 10 (27.8%)
1 (2.8%) 2 (5.6%) 1 (2.8%) 2 (5.6%) 0 (0.0%) 1 (2.8%) 1 (2.8%) 1 (2.8%) 1 (2.8%) 1 (2.8%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0.0%) 0 (0–2) 6.5 (4–14) 4 (11.1%)
> 0.999 0.289 > 0.999 > 0.999 > 0.999 > 0.999 > 0.999 > 0.999 > 0.999 > 0.999 > 0.999 0.500 > 0.999 > 0.999 0.513 0.040* 0.180
Statistically significant
Though it was not statistically significant, the complication rate in the robotic group was higher than the open group (36.1% vs 22.2%). We found that many of the postoperative complications happened in patients with primary hepatolithiasis and this diagnosis accounted for 19.4% in the robotic group in contrast to 5.6% in the open group. The
presence of infected bile in patients with intrahepatic ductal stones resulted in frequent postoperative i
Data Loading...
