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.

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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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