Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma

作者：Fabrizio Di Benedetto, Paolo Magistri, Stefano Di Sandro, Carlo Sposito, Christian Eugen Oberkofler, Ellie Brandon, Benjamin Samstein, Cristiano Guidetti, Alexandros Papageorgiou, Samuele Frassoni, Vincenzo Bagnardi, Pierre‐Alain Clavien, Davide Citterio, Tomoaki Kato, Henrik Petrowsky, Karim Jarir Halazun, Vincenzo Mazzaferro, Robotic HPB Study Group, Barbara Catellani, Gian Piero Guerrini, Jorgelina Clara Coppa, Maria Flores · 发表于：JAMA Surgery · 年份：2022 · DOI：10.1001/jamasurg.2022.5697 · 被引用次数：153 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cholangiocarcinoma and Gallbladder Cancer Studies、Intraperitoneal and Appendiceal Malignancies

Importance: Long-term oncologic outcomes of robotic surgery remain a hotly debated topic in surgical oncology, but sparse data have been published thus far. Objective: To analyze short- and long-term outcomes of robotic liver resection (RLR) for hepatocellular carcinoma (HCC) from Western high-volume centers to assess the safety, reproducibility, and oncologic efficacy of this technique. Design, Setting, and Participants: This cohort study evaluated the outcomes of patients receiving RLR vs open liver resection (OLR) for HCC between 2010 and 2020 in 5 high-volume centers. After 1:1 propensity score matching, a group of patients who underwent RLR was compared with a validation cohort of OLR patients from a high-volume center that did not perform RLR. Main Outcomes and Measures: A retrospective analysis was performed of prospectively maintained databases at 2 European and 2 US institutions of patients who underwent RLR for HCC between January 1, 2010, and September 30, 2020. The main outcomes were safety and feasibility of RLR for HCC and its oncologic outcomes compared with a European OLR validation cohort. A 2-sided P < .05 was considered significant. Results: The study included 398 patients (RLR group: 125 men, 33 women, median [IQR] age, 66 [58-71] years; OLR group: 315 men, 83 women; median [IQR] age, 70 [64-74] years), and 106 RLR patients were compared with 106 OLR patients after propensity score matching. The RLR patients had a significantly longer operative time (media...