Journal of pediatric surgery · 2026
Comparison of robotic and laparoscopic liver resection for pediatric liver tumor: A multicenter study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Wang Bo, Xia Xinrong, Wang Yuanli, Tang Chengyan, Gong Yuan, Huang Lu, Du Qing, Zhu Daiwei, Zhou Wangkan, Li Zeping, Jin Zhu, Liu Yuanmei, Tang Yingming, Zhang Guofeng, Tang Shaotao, Zheng Zebing
Аннотация
OBJECTIVE: To compare perioperative outcomes between robotic liver resection (RLR) and laparoscopic liver resection (LLR) in pediatric patients undergoing hepatectomy for liver tumors.
METHODS: This multicenter retrospective study included 77 pediatric patients who underwent RLR or LLR for liver tumors located in anterolateral (segments II, III, IVb, V, VI) or posterior (segments IVa, VII) segments between January 2015 and January 2025 across four tertiary centers. Baseline demographics, tumor characteristics, and perioperative outcomes were analyzed. Propensity score matching (PSM) was performed to minimize selection bias.
RESULTS: A total of 77 cases met the study criteria, of which 30 underwent RLR (39.0%) and 47 (61.0%) underwent LLR. After 1:1 PSM was performed (30 RLR vs. 30 LLR). RLR was associated with a shorter operative time [175 min (IQR:120, 256) vs. 245 min (IQR:180, 295); P <0.05], lower rates of Intraoperative blood transfusion[8 of 30(26.7%) vs. 16 of 30(53,3%); P <0.05], less blood loss [30.0 mL (IQR:18.8, 82.5) vs. 50 mL (IQR:30, 120); P <0.05], and lower rates of Pringle maneuver application [6 of 30(20.0%) vs. 17 of 30(56.7%); P <0.05]. On subset analysis of 38 patients with hepatoblastoma, of which 13 underwent RLR (34.2%) and 25 (65.8%) underwent LLR. After 1:1 PSM was performed (13 RLR vs. 13 LLR). RLR was associated with significantly shorter operative time [185 min (IQR:170, 210) vs. 270 min (IQR:255, 283); P <0.05], less blood loss [40 mL (IQR:25, 58) vs. 100 mL (IQR:75, 125); P <0.05], and lower rates of Pringle maneuver application [2 of 13(15.4%) vs. 9 of 13(69.2%); P <0.05] compared to LLR group. On the open conversion rates, post operative stay, postoperative complications, morbidity, mortality, and oncological outcomes were similar between RLR and LLR groups in the overall PSM cohort (P >0.05).
CONCLUSION: For hepatectomy in children with liver tumors such as hepatoblastoma, RLR is noninferior to LLR, with potential advantages in selected outcomes. Its benefits are manifested by shorter operative times, less blood loss, and a reduced need for intraoperative blood transfusion and vascular occlusion of hepatic portal.
METHODS: This multicenter retrospective study included 77 pediatric patients who underwent RLR or LLR for liver tumors located in anterolateral (segments II, III, IVb, V, VI) or posterior (segments IVa, VII) segments between January 2015 and January 2025 across four tertiary centers. Baseline demographics, tumor characteristics, and perioperative outcomes were analyzed. Propensity score matching (PSM) was performed to minimize selection bias.
RESULTS: A total of 77 cases met the study criteria, of which 30 underwent RLR (39.0%) and 47 (61.0%) underwent LLR. After 1:1 PSM was performed (30 RLR vs. 30 LLR). RLR was associated with a shorter operative time [175 min (IQR:120, 256) vs. 245 min (IQR:180, 295); P <0.05], lower rates of Intraoperative blood transfusion[8 of 30(26.7%) vs. 16 of 30(53,3%); P <0.05], less blood loss [30.0 mL (IQR:18.8, 82.5) vs. 50 mL (IQR:30, 120); P <0.05], and lower rates of Pringle maneuver application [6 of 30(20.0%) vs. 17 of 30(56.7%); P <0.05]. On subset analysis of 38 patients with hepatoblastoma, of which 13 underwent RLR (34.2%) and 25 (65.8%) underwent LLR. After 1:1 PSM was performed (13 RLR vs. 13 LLR). RLR was associated with significantly shorter operative time [185 min (IQR:170, 210) vs. 270 min (IQR:255, 283); P <0.05], less blood loss [40 mL (IQR:25, 58) vs. 100 mL (IQR:75, 125); P <0.05], and lower rates of Pringle maneuver application [2 of 13(15.4%) vs. 9 of 13(69.2%); P <0.05] compared to LLR group. On the open conversion rates, post operative stay, postoperative complications, morbidity, mortality, and oncological outcomes were similar between RLR and LLR groups in the overall PSM cohort (P >0.05).
CONCLUSION: For hepatectomy in children with liver tumors such as hepatoblastoma, RLR is noninferior to LLR, with potential advantages in selected outcomes. Its benefits are manifested by shorter operative times, less blood loss, and a reduced need for intraoperative blood transfusion and vascular occlusion of hepatic portal.