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Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study

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Abstract

Background

The recent development of 3D vision in laparoscopic and robotic surgical systems raises the question of whether these two procedures are equivalent. The aim of this study was to evaluate the surgical and long-term oncological outcomes of 3D laparoscopic (3D-LLR) and robotic liver resection (RLR) for hepatocellular carcinoma (HCC).

Methods

The data for operative time, morbidity, margins, and survival were reviewed for 3D-LLR and compared with RLR.

Results

From 2011 to 2017, 93 patients with HCC, including 58 (62%) with cirrhosis, underwent 3D-LLR [49 (53%)] or RLR [44 (47%)]. No difference was observed in operative time (269 vs. 252 min; p = 0.52), overall (27% vs. RLR: 16%; p = 0.49) and severe morbidity (4% vs. 2%; p = 0.77) or in the surgical margin width (9 vs. 11 mm; p = 0.30) between the 3D-LLR and RLR groups. The 3-year overall and recurrence-free survival rates after 3D-LLR and RLR were 82% and 24% and 91% (p = 0.16) and 48% (p = 0.18), respectively.

Conclusions

The 3D-LLR and RLR systems provide comparable surgical margins with similar short- and long-term oncological outcomes.

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Funding

The authors do not receive any funding from Intuitive or 3D laparoscopic system.

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Authors and Affiliations

  1. Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France

    Chetana Lim, Claire Goumard & Olivier Scatton

  2. Sorbonne Université, Paris, France

    Claire Goumard & Olivier Scatton

  3. Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Paul Brousse Hospital, Villejuif, France

    Chady Salloum & Daniel Azoulay

  4. Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

    Antonella Tudisco, Niccolo Napoli & Ugo Boggi

  5. Department of General Surgery and Transplantation, Hepatobiliary and Pancreatic Surgery, Tel Hashomer Hospital, Tel Aviv, Israel

    Daniel Azoulay

  6. Centre de Recherche de Saint-Antoine (CRSA), INSERM, UMRS-938, Paris, France

    Olivier Scatton

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  1. Chetana Lim
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Correspondence to Olivier Scatton.

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Disclosures

Dr. Chetana Lim, Dr. Claire Goumard, Dr. Chady Salloum, Dr. Antonella Tudisco, Dr. Niccolo Napoli, Prof. Ugo Boggi, Prof. Daniel Azoulay, and Prof. Olivier Scatton have no conflicts of interest or financial ties to disclose.

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Lim, C., Goumard, C., Salloum, C. et al. Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study. Surg Endosc 35, 3258–3266 (2021). https://doi.org/10.1007/s00464-020-07762-7

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  • DOI: https://doi.org/10.1007/s00464-020-07762-7

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