Robotic Versus Open Minor Liver Resections of the Posterosuperior Segments: A Multinational, Propensity Score-Matched Study

Background Minor liver resections of posterosuperior segments (1, 4A, 7, 8) are challenging to perform laparoscopically and are mainly performed using an open approach. We determined the feasibility of robotic resections of posterosuperior segments and compared short-term outcomes with the open appr...

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Published in:Annals of surgical oncology 2019-02, Vol.26 (2), p.583-590
Main Authors: Nota, Carolijn L., Woo, Yanghee, Raoof, Mustafa, Boerner, Thomas, Molenaar, I. Quintus, Choi, Gi Hong, Kingham, T. Peter, Latorre, Karen, Borel Rinkes, Inne H. M., Hagendoorn, Jeroen, Fong, Yuman
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Female
Follow-Up Studies
Hepatectomy - mortality
Hepatobiliary Tumors
Humans
Laparoscopy - mortality
Length of Stay
Liver
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Postoperative Complications
Propensity Score
Retrospective Studies
Robotic Surgical Procedures - mortality
Robotics
Surgery
Surgical Oncology
Survival Rate
Treatment Outcome
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Summary:Background Minor liver resections of posterosuperior segments (1, 4A, 7, 8) are challenging to perform laparoscopically and are mainly performed using an open approach. We determined the feasibility of robotic resections of posterosuperior segments and compared short-term outcomes with the open approach. Methods Data on open and robotic minor (≤ 3 segments) liver resections including the posterosuperior segments, performed between 2009 and 2016, were collected retrospectively from four hospitals. Robotic and open liver resections were compared, before and after propensity score matching. Results In total, 51 robotic and 145 open resections were included. After matching, 31 robotic resections were compared with 31 open resections. Median hospital stay was 4 days (interquartile range [IQR] 3–7) for the robotic group, versus 8 days (IQR 6–10) for the open group ( p   0.99). There was no mortality in either group. Conclusion Minor robotic liver resections of the posterosuperior segments are safe and feasible and display a shorter length of stay than open resections in selected patients at expert centers.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-018-6928-1