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British Journal of Surgery
Article . 2021 . Peer-reviewed
License: OUP Standard Publication Reuse
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International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior sectionectomy

Authors: Adrian K H Chiow; David Fuks; Gi-Hong Choi; Nicholas Syn; Iswanto Sucandy; Marco V Marino; Mikel Prieto; +32 Authors

International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior sectionectomy

Abstract

Abstract Background Minimally invasive right posterior sectionectomy (RPS) is a technically challenging procedure. This study was designed to determine outcomes following robotic RPS (R-RPS) and laparoscopic RPS (L-RPS). Methods An international multicentre retrospective analysis of patients undergoing R-RPS versus those who had purely L-RPS at 21 centres from 2010 to 2019 was performed. Patient demographics, perioperative parameters, and postoperative outcomes were analysed retrospectively from a central database. Propensity score matching (PSM) was performed, with analysis of 1 : 2 and 1 : 1 matched cohorts. Results Three-hundred and forty patients, including 96 who underwent R-RPS and 244 who had L-RPS, met the study criteria and were included. The median operating time was 295 minutes and there were 25 (7.4 per cent) open conversions. Ninety-seven (28.5 per cent) patients had cirrhosis and 56 (16.5 per cent) patients required blood transfusion. Overall postoperative morbidity rate was 22.1 per cent and major morbidity rate was 6.8 per cent. The median postoperative stay was 6 days. After 1 : 1 matching of 88 R-RPS and L-RPS patients, median (i.q.r.) blood loss (200 (100–400) versus 450 (200–900) ml, respectively; P < 0.001), major blood loss (> 500 ml; P = 0.001), need for intraoperative blood transfusion (10.2 versus 23.9 per cent, respectively; P = 0.014), and open conversion rate (2.3 versus 11.4 per cent, respectively; P = 0.016) were lower in the R-RPS group. Similar results were found in the 1 : 2 matched groups (66 R-RPS versus 132 L-RPS patients). Conclusion R-RPS and L-RPS can be performed in expert centres with good outcomes in well selected patients. R-RPS was associated with reduced blood loss and lower open conversion rates than L-RPS.

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Keywords

Male, Matched-Pair Analysis, Operative Time, Blood Loss, Surgical, 610, Blood Transfusion / statistics & numerical data, Laparoscopy*, Robotic Surgical Procedures, Surgical, Hepatectomy, Humans, Blood Loss, Blood Transfusion, Hepatectomy / methods*, Propensity Score, Surgical / statistics & numerical data, Robotic Surgical Procedures*, Aged, Retrospective Studies, Aged; Blood Loss, Surgical; Blood Transfusion; Conversion to Open Surgery; Female; Hepatectomy; Humans; Male; Matched-Pair Analysis; Middle Aged; Operative Time; Propensity Score; Retrospective Studies; Laparoscopy; Robotic Surgical Procedures, Middle Aged, Conversion to Open Surgery, Conversion to Open Surgery / statistics & numerical data, Female, Laparoscopy

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    popularity
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    influence
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
63
Top 1%
Top 10%
Top 1%
Green
hybrid