Minggen Hu1, Yanzhe Liu1, Chenggang Li1, Gang Wang1, Zhuzeng Yin1, Wan Yee Lau2, Rong Liu3. 1. Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese PLA General Hospital, Beijing, China. 2. Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China. Electronic address: josephlau@cuhk.edu.hk. 3. Department of Hepatobiliary and Pancreatic Surgical Oncology, Chinese PLA General Hospital, Beijing, China. Electronic address: liurong301@126.com.
Abstract
BACKGROUND: Laparoscopic liver resection is recommended as the standard operation for left lateral sectionectomy (LLS). Robotic liver resection is theoretically better than laparoscopic liver resection in complex cases of liver resection. However, in a complex case of LLS, whether robotic LLS (R-LLS) is still better than laparoscopic LLS (L-LLS) is unclear. This study aims to assess the perioperative outcomes of R-LLS and L-LLS in the overall and in the subgroup of complex cases of LLS. METHODS: From January 2015 to June 2017, the data on consecutive patients who underwent R-LLS were retrospectively compared with those who underwent L-LLS. Based on defined criteria for complex cases, the subgroup of such patients who underwent R-LLS were compared with the subgroup of patients who underwent L-LLS. The patient characteristics and surgical outcomes in the whole groups and subgroups of patients were analyzed. RESULTS: The overall R-LLS and L-LLS groups showed no significance differences in operative time, intraoperative blood loss, postoperative hospital stay, blood transfusion and morbidity rates. The overall medical costs were significantly higher in the R-LLS group than in the L-LLS group (12786.4 vs. 7974.3 USD; p < 0.001). On subgroup analysis of the complex cases, the estimated blood loss was significantly less in the R-LLS subgroup than the L-LLS subgroup (131.9 vs. 320.8 ml, p = 0.003). The two subgroups showed no significant differences in postoperative hospital stay (4.7 vs. 5.3 days; p = 0.054) and operative times (126.4 vs. 110.8 min; p = 0.379). The R-LLS subgroup had significantly higher overall medical costs than the L-LLS subgroup (13536.9 vs. 9186.7 USD, p = 0.006). CONCLUSION: The overall R-LLS group was comparable to the overall L-LLS group in perioperative outcomes. Although the overall medical costs in the robotic subgroup was higher, R-LLS might be a better choice for the subgroup of patients with complex cases when compared to L-LLS.
BACKGROUND: Laparoscopic liver resection is recommended as the standard operation for left lateral sectionectomy (LLS). Robotic liver resection is theoretically better than laparoscopic liver resection in complex cases of liver resection. However, in a complex case of LLS, whether robotic LLS (R-LLS) is still better than laparoscopic LLS (L-LLS) is unclear. This study aims to assess the perioperative outcomes of R-LLS and L-LLS in the overall and in the subgroup of complex cases of LLS. METHODS: From January 2015 to June 2017, the data on consecutive patients who underwent R-LLS were retrospectively compared with those who underwent L-LLS. Based on defined criteria for complex cases, the subgroup of such patients who underwent R-LLS were compared with the subgroup of patients who underwent L-LLS. The patient characteristics and surgical outcomes in the whole groups and subgroups of patients were analyzed. RESULTS: The overall R-LLS and L-LLS groups showed no significance differences in operative time, intraoperative blood loss, postoperative hospital stay, blood transfusion and morbidity rates. The overall medical costs were significantly higher in the R-LLS group than in the L-LLS group (12786.4 vs. 7974.3 USD; p < 0.001). On subgroup analysis of the complex cases, the estimated blood loss was significantly less in the R-LLS subgroup than the L-LLS subgroup (131.9 vs. 320.8 ml, p = 0.003). The two subgroups showed no significant differences in postoperative hospital stay (4.7 vs. 5.3 days; p = 0.054) and operative times (126.4 vs. 110.8 min; p = 0.379). The R-LLS subgroup had significantly higher overall medical costs than the L-LLS subgroup (13536.9 vs. 9186.7 USD, p = 0.006). CONCLUSION: The overall R-LLS group was comparable to the overall L-LLS group in perioperative outcomes. Although the overall medical costs in the robotic subgroup was higher, R-LLS might be a better choice for the subgroup of patients with complex cases when compared to L-LLS.
Authors: Ioannis A Ziogas; Alexandros P Evangeliou; Konstantinos S Mylonas; Dimitrios I Athanasiadis; Panagiotis Cherouveim; David A Geller; Richard D Schulick; Sophoclis P Alexopoulos; Georgios Tsoulfas Journal: Eur J Health Econ Date: 2021-03-19
Authors: Mirhasan Rahimli; Aristotelis Perrakis; Mihailo Andric; Jessica Stockheim; Mareike Franz; Joerg Arend; Sara Al-Madhi; Mohammed Abu Hilal; Andrew A Gumbs; Roland S Croner Journal: Cancers (Basel) Date: 2022-07-11 Impact factor: 6.575