Robotic versus laparoscopic left lateral sectionectomy of liver
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A few studies have reported only short-term outcomes of various robotic and laparoscopic liver resection types; however, published data in left lateral sectionectomy (LLS) have been limited. The aim of this study was to compare the long- and short-term outcomes of robotic and laparoscopic LLS.
We retrospectively compared demographic and perioperative data as well as postoperative outcomes of robotic (n = 12) and laparoscopic (n = 31) LLS performed between May 2007 and July 2013. Resection indications included malignant tumors (n = 31) and benign lesions (n = 12) including intrahepatic duct (IHD) stones (n = 9).
There were no significant differences in perioperative outcomes of estimated blood loss, major complications, or lengths of stay, but operating time was longer in robotic than in laparoscopic LLS (391 vs. 196 min, respectively) and the operation time for IHD stones did not differ between groups (435 vs. 405 min, respectively; p = 0.190). Disease-free (p = 0.463) and overall (p = 0.484) survival of patients with malignancy did not differ between groups. The 2- and 5-year disease-free survival rates were 63.2 and 36.5 %, respectively. However, robotic LLS costs were significantly higher than laparoscopic LLS costs ($8183 vs. $5190, respectively; p = 0.009).
Robotic LLS was comparable to laparoscopic LLS in surgical outcomes and oncologic integrity during the learning curve. Although robotic LLS was more expensive and time intensive, it might be a good option for difficult indications such as IHD stones.
KeywordsLaparoscopy Hepatectomy Laparoscopic surgical procedure
Compliance with ethical standards
Jae Keun Kim, Joon Seong Park, Dai Hoon Han, Gi Hong Choi, Kyung Sik Kim, Jin Sub Choi and Dong Sup Yoon have no conflicts of interest or financial ties to disclose.
- 19.Torzilli G, Makuuchi M, Inoue K, Takayama T, Sakamoto Y, Sugawara Y, Kubota K, Zucchi A (1999) No-mortality liver resection for hepatocellular carcinoma in cirrhotic and noncirrhotic patients: is there a way? A prospective analysis of our approach. Arch Surg 134(9):984–992CrossRefPubMedGoogle Scholar
- 22.Cherqui D, Laurent A, Tayar C, Chang S, Van Nhieu JT, Loriau J, Karoui M, Duvoux C, Dhumeaux D, Fagniez P-L (2006) Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg 243(4):499CrossRefPubMedPubMedCentralGoogle Scholar
- 28.Thompson JE, Egger S, Bohm M, Haynes AM, Matthews J, Rasiah K, Stricker PD (2014) Superior quality of life and improved surgical margins are achievable with robotic radical prostatectomy after a long learning curve: a prospective single-surgeon study of 1552 consecutive cases. Eur Urol 65(3):521–531CrossRefPubMedGoogle Scholar
- 30.Si Ariizumi, Kitagawa K, Kotera Y, Takahashi Y, Katagiri S, Kuwatsuru R, Yamamoto M (2011) A non-smooth tumor margin in the hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging predicts microscopic portal vein invasion, intrahepatic metastasis, and early recurrence after hepatectomy in patients with hepatocellular carcinoma. J Hepato-Biliary-Pancreat Sci 18(4):575–585CrossRefGoogle Scholar
- 33.Venkat P, Chen L-M, Young-Lin N, Kiet TK, Young G, Amatori D, Dasverma B, Yu X, Kapp DS, Chan JK (2012) An economic analysis of robotic versus laparoscopic surgery for endometrial cancer: costs, charges and reimbursements to hospitals and professionals. Gynecol Oncol 125(1):237–240CrossRefPubMedGoogle Scholar