World Journal of Surgery

, Volume 41, Issue 2, pp 516–524 | Cite as

Robotic-Assisted Versus Laparoscopic Left Lateral Sectionectomy: Analysis of Surgical Outcomes and Costs by a Propensity Score Matched Cohort Study

  • Chady Salloum
  • Chetana Lim
  • Eylon Lahat
  • Concepcion Gomez I. Gavara
  • Eric Levesque
  • Philippe Compagnon
  • Daniel Azoulay
Original Scientific Report

Abstract

Background

After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS.

Methods

All consecutive patients who underwent L-LLS or R-LLS from 1997 to 2014 were analyzed. Short-term and economic outcomes were compared between the two groups using a propensity score matching (PSM).

Results

Ninety-six consecutive cases of LLS were performed using the laparoscopic (80 cases; 83 %) or robotic (16 cases; 17 %) approach. The two groups were similar for operative and surgical outcomes. Operation time was similar in the R-LLS compared to the L-LLS group (190 vs. 162 min; p = 0.10). Perioperative costs were higher (1457 € vs. 576 €; p < 0.0001) in the R-LLS group than in the L-LLS group; however, postoperative costs were similar between the two groups (4065 € in the R-LLS group vs. 5459 € in the L-LLS group; p = 0.30). Total costs were similar between the two groups (5522 € in the R-LLS group vs. 6035€ in the L-LLS group; p = 0.70). The PSM included 14 patients for each group. Surgical and economic outcomes remained similar after PSM, except for total operating time which was significantly longer in the R-LLS group than in the L-LLS group.

Conclusions

Even if feasible and safe, the robotic approach does not seem so far to offer additional benefit in terms of intra- and postoperative outcomes over the laparoscopic approach in patients requiring LLS. Total costs associated with the R-LLS group are not greater than that associated with the L-LLS group, which is the standard of care so far.

Keywords

Liver Resection Propensity Score Match Laparoscopic Liver Resection Robotic Approach Robotic Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Chady Salloum
    • 1
  • Chetana Lim
    • 1
  • Eylon Lahat
    • 1
  • Concepcion Gomez I. Gavara
    • 1
  • Eric Levesque
    • 3
  • Philippe Compagnon
    • 1
    • 2
  • Daniel Azoulay
    • 1
    • 2
  1. 1.Department of Hepato-Biliary and Pancreatic Surgery and Liver TransplantationAP-HP Henri Mondor HospitalCréteilFrance
  2. 2.INSERM 955CréteilFrance
  3. 3.Department of Anesthesia and Liver Intensive Care UnitAP-HP Henri Mondor HospitalCréteilFrance

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