Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases.
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Cheung Tan-To, Liu Rong, Cipriani Federica, Wang Xiaoying, Efanov Mikhail, Fuks David, Choi Gi-Hong, Syn Nicholas L, Chong Charing C N, Di Benedetto Fabrizio, Robles-Campos Ricardo, Mazzaferro Vincenzo, Rotellar Fernando, Lopez-Ben Santiago, Park James O, Mejia Alejandro, Sucandy Iswanto, Chiow Adrian K H, Marino Marco V, Gastaca Mikel, Lee Jae Hoon, Kingham T Peter, D'Hondt Mathieu, Choi Sung Hoon, Sutcliffe Robert P, Han Ho-Seong, Tang Chung-Ngai, Pratschke Johann, Troisi Roberto I, Wakabayashi Go, Cherqui Daniel, Giuliante Felice, Aghayan Davit L, Edwin Bjorn, Scatton Olivier, Sugioka Atsushi, Long Tran Cong Duy, Fondevila Constantino, Abu Hilal Mohammad, Ruzzenente Andrea, Ferrero Alessandro, Herman Paulo, Chen Kuo-Hsin, Aldrighetti Luca, Goh Brian K P, International robotic and laparoscopic liver resection study group investigators*, International robotic and laparoscopic liver resection study group investigators
Аннотация
METHODS: This was a retrospective review of 971 patients who underwent LLR and RLR for huge (≥10 cm) tumors at 42 international centers between 2002-2020.
RESULTS: One hundred RLR and 699 LLR which met study criteria were included. The comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching (PSM) (73 vs. 219). Before PSM, LLR was associated with significantly increased frequency of previous abdominal surgery, malignant pathology, liver cirrhosis and increased median blood. After PSM, RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time (242 vs. 290 min, P=0.286), transfusion rate rate (19.2% vs. 16.9%, P=0.652), median blood loss (200 vs. 300 mL, P=0.694), open conversion rate (8.2% vs. 11.0%, P=0.519), morbidity (28.8% vs. 21.9%, P=0.221), major morbidity (4.1% vs. 9.6%, P=0.152), mortality and postoperative length of stay (6 vs. 6 days, P=0.435).
CONCLUSIONS: RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent outcomes. There was no significant difference in perioperative outcomes after RLR or LLR.