Short-Term Surgical Outcomes After Robotic Liver Surgery: A Propensity-Score Matched Analysis With Conventional Open Liver Surgery at a High-Volume Centre in Denmark

Int J Med Robot. 2024 Oct;20(5):e70003. doi: 10.1002/rcs.70003.

Abstract

Background: The aim of this study was to investigate the perioperative outcomes of robotic liver surgery (RLS) and Open liver surgery (OLS) in a centre with a high number of operations.

Methods: A 1:1 propensity score matched (PSM) analysis of a retrospective database of RLS and OLS was performed. Cumulative sum (CUSUM) analysis was performed to identify learning curves.

Result: After PSM analysis, operative time was significantly longer in the RLS group (p < 0.001). Estimated blood loss was significantly lower in the RLS group (p < 0.001). Transfusion rates were significantly lower in the RLS group. The length of hospital stay was shorter in the RLS group (3.5vs6.3 days, p < 0.001). Readmission rates were significantly lower in the RLS group (p < 0.049). CUSUM analysis showed a learning curve for at least 8 low-intermediate RLS procedures and 27 advanced-Expert RLS procedures.

Conclusions: RLS has many advantages, including being safe to perform, less blood loss and faster postoperative recovery compared with OLS.

Keywords: IWATE criteria; cumulative sum analysis; learning curve; open liver surgery; propensity‐score matched analysis; robotic liver surgery.

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical / statistics & numerical data
  • Denmark
  • Female
  • Hepatectomy* / methods
  • Humans
  • Learning Curve
  • Length of Stay* / statistics & numerical data
  • Liver / surgery
  • Male
  • Middle Aged
  • Operative Time*
  • Postoperative Complications / epidemiology
  • Propensity Score*
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Robotic Surgical Procedures* / statistics & numerical data
  • Treatment Outcome