Surgical outcomes after laparoscopic or robotic liver resection in hepatocellular carcinoma: a propensity-score matched analysis with conventional open liver resection

Int J Med Robot. 2016 Dec;12(4):735-742. doi: 10.1002/rcs.1714. Epub 2015 Nov 4.

Abstract

Background: This study was designed to compare perioperative and oncologic outcomes between minimally invasive liver resection (MILR) and conventional open liver resection (COLR) for hepatocellular carcinoma (HCC) using a propensity-score matched analysis.

Methods: Ninety-nine patients who received MILR were matched with 198 patients treated with COLR out of 928 patients with HCC who received curative liver resection from 2002 to 2012. A multivariable logistic model based on factors related to the patient, tumor, and surgical procedure was used to estimate a propensity score.

Results: The MILR group experienced significantly less intraoperative blood loss (mean: 389.55 vs 580.66 mL; P = 0.008), lower complication rates (13.1% vs 24.7%; P = 0.020), and a shorter length of hospital stay (mean: 8.40 vs 13.39 days; P < 0.001). The two groups did not differ significantly in disease-free (P = 0.701) or overall survival (P = 0.086).

Conclusions: MILR produced better perioperative and comparable oncologic outcomes than COLR for HCC. Copyright © 2015 John Wiley & Sons, Ltd.

Keywords: hepatectomy; hepatocellular carcinoma; laparoscopy; propensity score; robotics.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical
  • Carcinoma, Hepatocellular / surgery*
  • Case-Control Studies
  • Disease-Free Survival
  • Female
  • Hepatectomy / methods
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Liver / surgery*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Multivariate Analysis
  • Propensity Score
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome