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International multicentre propensity score-matched analysis comparing robotic versus laparoscopic right posterior
Adrian K H Chiow1, David Fuks2, Gi-Hong Choi3
1Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore.
The British Journal of Surgery
|November 9, 2021
Summary
Robotic right posterior sectionectomy (R-RPS) shows improved outcomes compared to laparoscopic RPS (L-RPS). R-RPS demonstrated significantly reduced blood loss and lower conversion rates in expert centers.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Robotic surgery
Background:
- Right posterior sectionectomy (RPS) is a complex minimally invasive procedure.
- Outcomes of robotic RPS (R-RPS) versus laparoscopic RPS (L-RPS) require detailed comparison.
Purpose of the Study:
- To compare perioperative and postoperative outcomes between R-RPS and L-RPS.
- To evaluate the safety and efficacy of robotic assistance in RPS.
Main Methods:
- International multicentre retrospective analysis (2010-2019).
- Inclusion of 340 patients (96 R-RPS, 244 L-RPS).
- Propensity score matching (1:1 and 1:2) for cohort comparison.
Main Results:
- R-RPS group showed significantly lower median blood loss (200 vs. 450 ml) and major blood loss (P < 0.001).
- Lower intraoperative blood transfusion rates (10.2% vs. 23.9%, P=0.014) and open conversion rates (2.3% vs. 11.4%, P=0.016) in the R-RPS group.
- Similar overall and major postoperative morbidity rates between groups.
Conclusions:
- Both R-RPS and L-RPS can achieve good outcomes in selected patients at expert centers.
- R-RPS is associated with reduced blood loss and fewer open conversions compared to L-RPS.
