Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study

Felix Krenzien; Moritz Schmelzle; Johann Pratschke; Linda Feldbrügge; Rong Liu; Qu Liu; Wanguang Zhang; Joseph J. Zhao; Hwee-Leong Tan; Federica Cipriani; Tijs J. Hoogteijling; Davit L. Aghayan; Åsmund A. Fretland; Tiing Foong Siow; Chetana Lim; Olivier Scatton; Paulo Herman; Fabricio F. Coelho; Marco V. Marino; Vincenzo Mazzaferro; Adrian K.H. Chiow; Iswanto Sucandy; Arpad Ivanecz; Sung Hoon Choi; Jae Hoon Lee; Mikel Gastaca; Marco Vivarelli; Felice Giuliante; Bernardo Dalla Valle; Andrea Ruzzenente; Chee-Chien Yong; Zewei Chen; Mengqiu Yin; Constantino Fondevila; Mikhail Efanov; Zenichi Morise; Fabrizio Di Benedetto; Raffaele Brustia; Raffaele Dalla Valle; Ugo Boggi; David Geller; Andrea Belli; Riccardo Memeo; Salvatore Gruttadauria; Alejandro Mejia; James O. Park; Fernando Rotellar; Gi-Hong Choi; Ricardo Robles-Campos; Xiaoying Wang; Robert P. Sutcliffe; Kiyoshi Hasegawa; Chung-Ngai Tang; Charing C. N. Chong; Kit-Fai Lee; Juul Meurs; Mathieu D'Hondt; Kazuteru Monden; Santiago Lopez-Ben; T. Peter Kingham; Alessandro Ferrero; Giuseppe M. Ettorre; Franco Pascual; Daniel Cherqui; Junhao Zheng; Xiao Liang; Olivier Soubrane; Go Wakabayashi; Roberto I. Troisi; Tan-To Cheung; Yutaro Kato; Atsushi Sugioka; Safi Dokmak; Mizelle D'Silva; Ho-Seong Han; Phan Phuoc Nghia; Tran Cong Duy Long; Mohammad Abu Hilal; Kuo-Hsin Chen; David Fuks; Luca Aldrighetti; Bjørn Edwin; Brian K. P. Goh

doi:10.1097/SLA.0000000000006027

Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study

Felix Krenzien, Moritz Schmelzle, Johann Pratschke, Linda Feldbrügge, Rong Liu, Qu Liu, Wanguang Zhang, Joseph J. Zhao, Hwee-Leong Tan, Federica Cipriani, Tijs J. Hoogteijling, Davit L. Aghayan, Åsmund A. Fretland, Tiing Foong Siow, Chetana Lim, Olivier Scatton, Paulo Herman, Fabricio F. Coelho, Marco V. Marino, Vincenzo MazzaferroAdrian K.H. Chiow, Iswanto Sucandy, Arpad Ivanecz, Sung Hoon Choi, Jae Hoon Lee, Mikel Gastaca, Marco Vivarelli, Felice Giuliante, Bernardo Dalla Valle, Andrea Ruzzenente, Chee-Chien Yong, Zewei Chen, Mengqiu Yin, Constantino Fondevila, Mikhail Efanov, Zenichi Morise, Fabrizio Di Benedetto, Raffaele Brustia, Raffaele Dalla Valle, Ugo Boggi, David Geller, Andrea Belli, Riccardo Memeo, Salvatore Gruttadauria, Alejandro Mejia, James O. Park, Fernando Rotellar, Gi-Hong Choi, Ricardo Robles-Campos, Xiaoying Wang, Robert P. Sutcliffe, Kiyoshi Hasegawa, Chung-Ngai Tang, Charing C. N. Chong, Kit-Fai Lee, Juul Meurs, Mathieu D'Hondt, Kazuteru Monden, Santiago Lopez-Ben, T. Peter Kingham, Alessandro Ferrero, Giuseppe M. Ettorre, Franco Pascual, Daniel Cherqui, Junhao Zheng, Xiao Liang, Olivier Soubrane, Go Wakabayashi, Roberto I. Troisi, Tan-To Cheung, Yutaro Kato, Atsushi Sugioka, Safi Dokmak, Mizelle D'Silva, Ho-Seong Han, Phan Phuoc Nghia, Tran Cong Duy Long, Mohammad Abu Hilal, Kuo-Hsin Chen, David Fuks, Luca Aldrighetti, Bjørn Edwin, Brian K. P. Goh

Risultato della ricerca: Contributo in rivista › Articolo in rivista

Abstract

Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: And 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.

Lingua originale	English
pagine (da-a)	297-305
Numero di pagine	9
Rivista	Annals of Surgery
Volume	279
DOI	https://doi.org/10.1097/SLA.0000000000006027
Stato di pubblicazione	Pubblicato - 2024

Keywords

laparoscopic liver resection
liver cirrhosis
robotic liver resection
posterosuperior liver segments
minimally-invasive hepatectomy

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10.1097/SLA.0000000000006027

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Krenzien, F., Schmelzle, M., Pratschke, J., Feldbrügge, L., Liu, R., Liu, Q., Zhang, W., Zhao, J. J., Tan, H.-L., Cipriani, F., Hoogteijling, T. J., Aghayan, D. L., Fretland, Å. A., Siow, T. F., Lim, C., Scatton, O., Herman, P., Coelho, F. F., Marino, M. V., ... Goh, B. K. P. (2024). Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study. Annals of Surgery, 279, 297-305. https://doi.org/10.1097/SLA.0000000000006027

@article{dbcee5c3c8e7479a81ac9eb3f69b79e0,

title = "Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study",

abstract = "Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: And 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.",

keywords = "laparoscopic liver resection, liver cirrhosis, robotic liver resection, posterosuperior liver segments, minimally-invasive hepatectomy, laparoscopic liver resection, liver cirrhosis, robotic liver resection, posterosuperior liver segments, minimally-invasive hepatectomy",

author = "Felix Krenzien and Moritz Schmelzle and Johann Pratschke and Linda Feldbr{\"u}gge and Rong Liu and Qu Liu and Wanguang Zhang and Zhao, {Joseph J.} and Hwee-Leong Tan and Federica Cipriani and Hoogteijling, {Tijs J.} and Aghayan, {Davit L.} and Fretland, {{\AA}smund A.} and Siow, {Tiing Foong} and Chetana Lim and Olivier Scatton and Paulo Herman and Coelho, {Fabricio F.} and Marino, {Marco V.} and Vincenzo Mazzaferro and Chiow, {Adrian K.H.} and Iswanto Sucandy and Arpad Ivanecz and Choi, {Sung Hoon} and Lee, {Jae Hoon} and Mikel Gastaca and Marco Vivarelli and Felice Giuliante and {Dalla Valle}, Bernardo and Andrea Ruzzenente and Chee-Chien Yong and Zewei Chen and Mengqiu Yin and Constantino Fondevila and Mikhail Efanov and Zenichi Morise and {Di Benedetto}, Fabrizio and Raffaele Brustia and {Dalla Valle}, Raffaele and Ugo Boggi and David Geller and Andrea Belli and Riccardo Memeo and Salvatore Gruttadauria and Alejandro Mejia and Park, {James O.} and Fernando Rotellar and Gi-Hong Choi and Ricardo Robles-Campos and Xiaoying Wang and Sutcliffe, {Robert P.} and Kiyoshi Hasegawa and Chung-Ngai Tang and Chong, {Charing C. N.} and Kit-Fai Lee and Juul Meurs and Mathieu D'Hondt and Kazuteru Monden and Santiago Lopez-Ben and Kingham, {T. Peter} and Alessandro Ferrero and Ettorre, {Giuseppe M.} and Franco Pascual and Daniel Cherqui and Junhao Zheng and Xiao Liang and Olivier Soubrane and Go Wakabayashi and Troisi, {Roberto I.} and Tan-To Cheung and Yutaro Kato and Atsushi Sugioka and Safi Dokmak and Mizelle D'Silva and Ho-Seong Han and Nghia, {Phan Phuoc} and Long, {Tran Cong Duy} and Hilal, {Mohammad Abu} and Kuo-Hsin Chen and David Fuks and Luca Aldrighetti and Bj{\o}rn Edwin and Goh, {Brian K. P.}",

year = "2024",

doi = "10.1097/SLA.0000000000006027",

language = "English",

volume = "279",

pages = "297--305",

journal = "Annals of Surgery",

issn = "0003-4932",

publisher = "Wolters Kluwer Health",

}

Krenzien, F, Schmelzle, M, Pratschke, J, Feldbrügge, L, Liu, R, Liu, Q, Zhang, W, Zhao, JJ, Tan, H-L, Cipriani, F, Hoogteijling, TJ, Aghayan, DL, Fretland, ÅA, Siow, TF, Lim, C, Scatton, O, Herman, P, Coelho, FF, Marino, MV, Mazzaferro, V, Chiow, AKH, Sucandy, I, Ivanecz, A, Choi, SH, Lee, JH, Gastaca, M, Vivarelli, M, Giuliante, F, Dalla Valle, B, Ruzzenente, A, Yong, C-C, Chen, Z, Yin, M, Fondevila, C, Efanov, M, Morise, Z, Di Benedetto, F, Brustia, R, Dalla Valle, R, Boggi, U, Geller, D, Belli, A, Memeo, R, Gruttadauria, S, Mejia, A, Park, JO, Rotellar, F, Choi, G-H, Robles-Campos, R, Wang, X, Sutcliffe, RP, Hasegawa, K, Tang, C-N, Chong, CCN, Lee, K-F, Meurs, J, D'Hondt, M, Monden, K, Lopez-Ben, S, Kingham, TP, Ferrero, A, Ettorre, GM, Pascual, F, Cherqui, D, Zheng, J, Liang, X, Soubrane, O, Wakabayashi, G, Troisi, RI, Cheung, T-T, Kato, Y, Sugioka, A, Dokmak, S, D'Silva, M, Han, H-S, Nghia, PP, Long, TCD, Hilal, MA, Chen, K-H, Fuks, D, Aldrighetti, L, Edwin, B & Goh, BKP 2024, 'Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study', Annals of Surgery, vol. 279, pagg. 297-305. https://doi.org/10.1097/SLA.0000000000006027

TY - JOUR

T1 - Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study

AU - Krenzien, Felix

AU - Schmelzle, Moritz

AU - Pratschke, Johann

AU - Feldbrügge, Linda

AU - Liu, Rong

AU - Liu, Qu

AU - Zhang, Wanguang

AU - Zhao, Joseph J.

AU - Tan, Hwee-Leong

AU - Cipriani, Federica

AU - Hoogteijling, Tijs J.

AU - Aghayan, Davit L.

AU - Fretland, Åsmund A.

AU - Siow, Tiing Foong

AU - Lim, Chetana

AU - Scatton, Olivier

AU - Herman, Paulo

AU - Coelho, Fabricio F.

AU - Marino, Marco V.

AU - Mazzaferro, Vincenzo

AU - Chiow, Adrian K.H.

AU - Sucandy, Iswanto

AU - Ivanecz, Arpad

AU - Choi, Sung Hoon

AU - Lee, Jae Hoon

AU - Gastaca, Mikel

AU - Vivarelli, Marco

AU - Giuliante, Felice

AU - Dalla Valle, Bernardo

AU - Ruzzenente, Andrea

AU - Yong, Chee-Chien

AU - Chen, Zewei

AU - Yin, Mengqiu

AU - Fondevila, Constantino

AU - Efanov, Mikhail

AU - Morise, Zenichi

AU - Di Benedetto, Fabrizio

AU - Brustia, Raffaele

AU - Dalla Valle, Raffaele

AU - Boggi, Ugo

AU - Geller, David

AU - Belli, Andrea

AU - Memeo, Riccardo

AU - Gruttadauria, Salvatore

AU - Mejia, Alejandro

AU - Park, James O.

AU - Rotellar, Fernando

AU - Choi, Gi-Hong

AU - Robles-Campos, Ricardo

AU - Wang, Xiaoying

AU - Sutcliffe, Robert P.

AU - Hasegawa, Kiyoshi

AU - Tang, Chung-Ngai

AU - Chong, Charing C. N.

AU - Lee, Kit-Fai

AU - Meurs, Juul

AU - D'Hondt, Mathieu

AU - Monden, Kazuteru

AU - Lopez-Ben, Santiago

AU - Kingham, T. Peter

AU - Ferrero, Alessandro

AU - Ettorre, Giuseppe M.

AU - Pascual, Franco

AU - Cherqui, Daniel

AU - Zheng, Junhao

AU - Liang, Xiao

AU - Soubrane, Olivier

AU - Wakabayashi, Go

AU - Troisi, Roberto I.

AU - Cheung, Tan-To

AU - Kato, Yutaro

AU - Sugioka, Atsushi

AU - Dokmak, Safi

AU - D'Silva, Mizelle

AU - Han, Ho-Seong

AU - Nghia, Phan Phuoc

AU - Long, Tran Cong Duy

AU - Hilal, Mohammad Abu

AU - Chen, Kuo-Hsin

AU - Fuks, David

AU - Aldrighetti, Luca

AU - Edwin, Bjørn

AU - Goh, Brian K. P.

PY - 2024

Y1 - 2024

N2 - Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: And 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.

AB - Objective: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. Background: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. Methods: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. Results: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: And 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P=0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P<0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P<0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P=0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P<0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P=0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. Conclusions: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.

KW - laparoscopic liver resection

KW - liver cirrhosis

KW - robotic liver resection

KW - posterosuperior liver segments

KW - minimally-invasive hepatectomy

KW - laparoscopic liver resection

KW - liver cirrhosis

KW - robotic liver resection

KW - posterosuperior liver segments

KW - minimally-invasive hepatectomy

UR - http://hdl.handle.net/10807/302100

U2 - 10.1097/SLA.0000000000006027

DO - 10.1097/SLA.0000000000006027

M3 - Article

SN - 0003-4932

VL - 279

SP - 297

EP - 305

JO - Annals of Surgery

JF - Annals of Surgery

ER -

Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study

Abstract

Keywords

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