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

Lim, Chetana; Goumard, Claire; Salloum, Chady; Tudisco, Antonella; Napoli, Niccolò; Boggi, Ugo; Azoulay, Daniel; Scatton, Olivier

doi:10.1007/s00464-020-07762-7

Cited by 18 publications

(11 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study by Lim et al 16 analyzed data from all consecutive patients who underwent minimally invasive liver resection for HCC, using data from 3 European settings (3 Western hepatobiliary departments): center 1: Henri Mondor Hospital, Créteil, France; center 2: Cisanello Hospital, Pisa, Italy from 2011 to 2017; and center 3: Pitié‐Salpêtrière Hospital, Paris, France (center 3) from 2015 to 2017. Centers 1 and 2 contained all patients with HCC who underwent robotic surgery and were compared with center 3, who underwent 3D laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of robotic‐assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma

Duong

Cai

Shrubsole

et al. 2021

Cancer

View full text Add to dashboard Cite

Background This article investigated whether robotic‐assisted liver surgery versus laparoscopic liver surgical treatment of hepatocellular carcinoma (HCC) has similar or different short‐ and long‐term clinical outcomes. Methods A total of 3049 patients from the National Cancer Database who received minimally invasive surgery (ie, robotic or laparoscopic surgery) for stage I HCC cancers between 2010 to 2015, of which 123 had robotic and 2926 had laparoscopic surgeries performed, were identified. Logistic regression was applied to evaluate short‐term outcomes. Cox proportional hazards models were applied to estimate all‐cause mortality at 1‐year, 3‐years, and 5‐years after surgery, adjusting for potential confounders. Propensity score‐matched analyses were conducted to compare long‐term outcomes between robotic and laparoscopic surgeries. Results Robotic surgery was associated with improved overall survival, with 1‐, 3‐, and 5‐year survival rates (SRs) of 0.92, 0.75, and 0.63 compared with laparoscopic surgery SRs of 0.86, 0.60, and 0.45, respectively (P value <.01). Multivariate analyses showed that robotic compared with laparoscopic surgery had significantly lower 5‐year total mortality (hazard ratio [HR], 0.64 and 95% confidence interval [CI], 0.45%‐0.93% for intent‐to‐treat; HR, 0.62 and 95% CI, 0.42%‐0.91% for end‐treatment analyses). Similar results were found in propensity score matched analyses; robotic surgery was associated with improved overall survival compared with laparoscopic surgery (HR, 0.64 and 95% CI, 0.43%‐0.96% for intent‐to‐treat; HR, 0.59 and 95% CI, 0.39%‐0.90% for end‐treatment). Conclusions Robotic surgery is not inferior to laparoscopic surgery in treating early‐stage HCC and may be associated with improved long‐term survival.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes of robotic‐assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma

Duong

Cai

Shrubsole

et al. 2021

Cancer

View full text Add to dashboard Cite

show abstract

“…However, the evidence for possible advantages and disadvantages compared to laparoscopic liver surgery is still low. The available publications are mostly case reports, small feasibility series, and isolated retrospective mono-center analyses, and sometimes pooled multicenter studies due to small patient numbers [ 14 ].…”

Section: Robotic Resection Of Primary Hepatic Tumorsmentioning

confidence: 99%

Robotic-Assisted Surgery for Primary Hepatobiliary Tumors—Possibilities and Limitations

Spiegelberg

Iken

Fichtner‐Feigl

2022

Cancers

View full text Add to dashboard Cite

Hepatocellular and cholangiocellular carcinoma are fatal primary hepatic tumors demanding extensive liver resection. Liver surgery is technically challenging due to the complex liver anatomy, with an intensive and variant vascular and biliary system. Therefore, major hepatectomies in particular are often performed by open resection and minor hepatectomies are often performed minimally invasively. More centers have adopted robotic-assisted surgery, intending to improve the laparoscopic surgical limits, as it offers some technical benefits such as seven degrees of freedom and 3D visualization. The da Vinci® Surgical System has dominated the surgical robot market since 2000 and has shown surgical feasibility, but there is still much controversy about its economic benefits and real benefits for the patient over the gold standard. The currently available retrospective case studies are difficult to compare, and larger, prospective studies and randomized trials are still urgently missing. Therefore, here we summarize the technical, surgical, and economic outcomes of robotic versus open and laparoscopic hepatectomies for primary liver tumors found in the latest literature reviews and meta-analyses. We conclude that complex robotic liver resections (RLR) are safe and feasible after the steep learning curve of the surgical team has plateaued. The financial burden is lower in high volume centers and is expected to decrease soon as new surgical systems will enter the market.

show abstract

“…All studies were of retrospective design; five studies compared RAH to LH [ 13 , 15 , 16 , 17 , 18 ]. A comparison between OH and RAH was done by three studies [ 14 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

“…The overview of the study selection process is depicted in Figure 1 and a description of included studies is provided in Table 1. All studies were of retrospective design; five studies compared RAH to LH [13,[15][16][17][18]. A comparison between OH and RAH was done by three studies [14,19,20].…”

Section: Resultsmentioning

confidence: 99%

Innovation for the Sake of Innovation? How Does Robotic Hepatectomy Compare to Laparoscopic or Open Resection for HCC—A Systematic Review and Meta-Analysis

Murtha-Lemekhova

Fuchs

Hoffmann

2022

Cancers

View full text Add to dashboard Cite

Robot-assisted hepatectomy is a novel approach to treat liver tumors. HCC is on the rise as the cause of cancer and mortality and is often preceded by cirrhosis. Robot-assisted hepatectomy has been suggested to offer benefits to cirrhotic patients. We aimed to evaluate current evidence for robot-assisted hepatectomy for HCC and compare it to open and laparoscopic approaches. This systematic review and meta-analysis has been conducted in accordance with most recent PRISMA recommendations and the protocol has been registered at PROSPERO (CRD42022328544). There were no randomized controlled trials available and no study focused on cirrhotic patients exclusively. Robot-assisted hepatectomy was associated with less major complications than the laparoscopic approach, but comparable with open hepatectomy. No difference was seen in overall or minor complications, as well as liver specific or infectious complications. Cumulative survivals were similar in robot-assisted hepatectomy and laparoscopic or open approaches. There is a clear lack of evidence to suggest particular benefits for robot-assisted hepatectomy in cirrhotic patients. Otherwise, the robot-assisted approach has similar complication rates as open or laparoscopic methods. Non-industry driven randomized controlled trials are needed to evaluate the efficacy of robot-assisted liver surgery.

show abstract

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

Cited by 18 publications

References 31 publications

Outcomes of robotic‐assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma

Outcomes of robotic‐assisted liver surgery versus laparoscopic liver surgery for treatment of stage I hepatocellular carcinoma

Robotic-Assisted Surgery for Primary Hepatobiliary Tumors—Possibilities and Limitations

Innovation for the Sake of Innovation? How Does Robotic Hepatectomy Compare to Laparoscopic or Open Resection for HCC—A Systematic Review and Meta-Analysis

Contact Info

Product

Resources

About