Novel Benchmark for Robotic Liver Resection – Bridging Tradition with Innovation

作者：Zhihao Li, Matthias Pfister, Dimitri Aristotle Raptis, Yong Ma, Guangchao Yang, Linqiang Li, Xuan Song, Guillaume Y. Millet, Stéphanie Truant, Raphael Venezia, Heithem Jeddou, Bastien Le Floc’h, A. Valverde, N. Péru, Patrick Pessaux, Fabio Giannone, Jean‐Yves Mabrut, Kayvan Mohkam, António Sá Cunha, Chady Salloum, P. Blanc, Bertrand Le Roy, Claire Goumard, Olivier Scatton, Stylianos Tzedakis, David Fuks, Ismaël Chaoui, Ashwin Rammohan, Silvia Gomes da Silva, M. Sobral, Víctor López‐López, Leonardo Centonze, Zhu Zhu, Francesca Ratti, Rebecca Marino, Gianluca Rompianesi, Yawen Dong, Jimmy Shah, Philip C. Müller, Taiga Wakabayashi, Fabrício Ferreira Coelho, Samy Castillo‐Flores, Bo Ram Lee, Virginia Viti, Yutaro Kato, Ugo Boggi, Ho-Seong Han, Patricio M. Polanco, Brian K. P. Goh, Tan To Cheung, Михаил Ефанов, Fabrizio Panaro, Marcel Cerqueira César Machado, Paulo Herman, Go Wakabayashi, Benedetto Ielpo, Beat P. Müller‐Stich, Alejandro Mejia, Patrick Starlinger, John B. Martinie, Roberto I. Troisi, Luca Aldrighetti, Guodong Chen, R Robles, Gi Hong Choi, Rong Liu, Fabrizio Di Benedetto, Hugo P. Marques, Iswanto Sucandy, Mohamed Rela, Mathieu D’Hondt, Raffaele Brustia, Olivier Soubrane, Dieter C. Bröering, Pierre‐Alain Clavien · 发表于：Annals of Surgery · 年份：2025 · DOI：10.1097/sla.0000000000006759 · 被引用次数：10 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Advanced Radiotherapy Techniques、Cholangiocarcinoma and Gallbladder Cancer Studies

OBJECTIVE: To establish benchmark cutoffs for robotic liver resection (R-LR), encompassing both major and minor resections, and to determine the impact of patient selection on outcomes. BACKGROUND: R-LR is a key advancement in minimally invasive liver surgery but lacks standardized benchmarks, especially for minor resections. While guidelines endorse R-LR, its role in optimizing outcomes remains unclear. This study establishes the first benchmarks for R-LR, enabling comparisons across surgical modalities and refining patient selection. METHODS: This retrospective, multicenter study analyzed consecutive adult patients undergoing R-LR at 30 international centers (2020-2023). Benchmark centers had an annual case volume of ≥15 R-LR. Benchmark criteria included ASA ≤2, no major comorbidities, no prior liver resections, and Child-Pugh A status. Benchmark cutoffs for 14 key outcomes were set at the 50th and 75th percentiles of median values across benchmark centers. Multivariable logistic regression identified predictors of textbook outcomes. RESULTS: Eighteen high-volume centers contributed 4028 cases with 2632 (65.3%) meeting benchmark criteria. Malignancy was the indication in 29.6%, most commonly hepatocellular carcinoma followed by colorectal liver metastases. Major liver resection was performed in 42.6%. The distribution of Iwate difficulty scores was low (25.4%), intermediate (53.9%), advanced (15.9%), and expert (4.9%). Benchmark cutoffs were established for minor and major ...