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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2017

01-04-2017 | Hepatobiliary Tumors

Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison

Authors: Po-Da Chen, MD, Chao-Ying Wu, MD, Rey-Heng Hu, MD, PhD, Wei-Han Chou, MD, Hong-Shiee Lai, MD, PhD, Jin-Tung Liang, MD, PhD, Po-Huang Lee, MD, PhD, Yao-Ming Wu, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2017

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Abstract

Background

Robotic hepatectomy has been suggested to be a safe and effective approach for liver disease; however, studies comparing robotic hepatectomy with the conventional open approach regarding oncologic outcomes for hepatocellular carcinoma (HCC) are limited. Accordingly, we performed a matched comparison of surgical and oncological outcomes between robotic and open hepatectomy.

Methods

Between January 2012 and October 2015, a total of 183 patients underwent robotic hepatectomy and 275 patients underwent open hepatectomy by the same surgical team in our center. Eighty-one newly diagnosed HCC cases in each group were compared under propensity score matching (PSM) in a 1:1 ratio.

Results

With robotic hepatectomy, the conversion rate was 1.6 % and the complication rate was 4.4 %. On PSM, the groups had a comparable percentage of major liver resections (41.9 vs. 39.5 %) and liver cirrhosis (45.7 vs. 46.9 %). Compared with the open group, the robotic group required longer operation times (343 vs. 220 min), shorter hospital stays (7.5 vs. 10.1 days), and lower dosages of postoperative patient-controlled analgesia (350 vs. 554 ng/kg). The 3-year disease-free survival of the robotic group was comparable with that of the open group (72.2 % vs. 58.0 %; p = 0.062), as was the 3-year overall survival (92.6 vs. 93.7 %; p = 0.431).

Conclusions

This is the first oncological study comparing robotic liver resection for HCC with open resection. Robotic hepatectomy can be applied for challenging major resections in patients with cirrhotic liver disease with less postoperative pain and shorter hospital stays without compromising oncological outcomes.
Appendix
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Metadata
Title
Robotic Versus Open Hepatectomy for Hepatocellular Carcinoma: A Matched Comparison
Authors
Po-Da Chen, MD
Chao-Ying Wu, MD
Rey-Heng Hu, MD, PhD
Wei-Han Chou, MD
Hong-Shiee Lai, MD, PhD
Jin-Tung Liang, MD, PhD
Po-Huang Lee, MD, PhD
Yao-Ming Wu, MD, PhD
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5638-9

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