Surgical Endoscopy

, Volume 30, Issue 3, pp 1004–1013 | Cite as

Robotic versus laparoscopic resections of posterosuperior segments of the liver: a propensity score-matched comparison

  • Roberto Montalti
  • Vincenzo Scuderi
  • Alberto Patriti
  • Marco Vivarelli
  • Roberto I. Troisi
Article

Abstract

Background

Open parenchymal-preserving resection is the current standard of care for lesions in the posterosuperior liver segments. Laparoscopy and robot-assisted surgery are emergent surgical approaches for liver resections, even in posteriorly located lesions. The objective of this study was to compare robot-assisted to laparoscopic parenchymal-preserving liver resections for lesions located in segments 7, 8, 4a, and 1.

Methods

Demographics, comorbidities, clinicopathologic characteristics, surgical treatments, and outcomes from patients who underwent laparoscopic and robot-assisted liver resection in two centers for lesions in the posterosuperior segments between June 2008 and February 2014 were reviewed. A 1:2 matched propensity score analysis was performed by individually matching patients in the robotic cohort to patients in the laparoscopic cohort based on demographics, comorbidities, performance status, tumor stage, location, and type of resection.

Results

Thirty-six patients who underwent robot-assisted liver resection were matched with 72 patients undergoing laparoscopic liver resection. Matched patients displayed no significant differences in postoperative outcomes as measured by blood loss, hospital stay, R0 negative margin rate, and mortality. The overall morbidity according to the comprehensive complication index was also similar (34.6 ± 33 vs. 18.4 ± 11.3, respectively, for robotic and laparoscopic approach, p = 0.11). Patients undergoing robotic liver surgery had significantly longer inflow occlusion time (77 vs. 25 min, p = 0.001) as compared with their laparoscopic counterparts.

Conclusions

Although number and severity of complications in the robotic group appears to be higher, robotic and laparoscopic parenchymal-preserving liver resections in the posterosuperior segments display similar safety and feasibility.

Keywords

Robotic liver resections Laparoscopic liver resections Posterosuperior segments Propensity score 

Notes

Disclosures

Roberto Montalti, Vincenzo Scuderi, Alberto Patriti, Marco Vivarelli, and Roberto I. Troisi declared that have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Roberto Montalti
    • 1
    • 3
  • Vincenzo Scuderi
    • 3
  • Alberto Patriti
    • 2
  • Marco Vivarelli
    • 1
  • Roberto I. Troisi
    • 3
  1. 1.Department. of Gastroenterology and Transplantation SurgeryOspedali Riuniti AnconaAnconaItaly
  2. 2.Division. of General, Minimally Invasive and Robotic SurgeryGeneral Hospital of SpoletoSpoletoItaly
  3. 3.Department. of General and Hepato-Biliary Surgery, Liver Transplantation ServiceGhent University Hospital Medical SchoolGhentBelgium

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