Robot-assisted hemihepatectomy is superior to laparoscopic hemihepatectomy through dorsal approach:A propensity score-matched study(with videos)  

作　　者：Kun Wang Dong-Dong Xie Jin Peng Chao-Bo Chen Yang Yue Ya-Juan Cao De-Cai Yu 

机构地区：[1]Division of Hepatobiliary and Transplantation Surgery,Department of General Surgery,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing Medical University,Nanjing 210008,China

出　　处：《Hepatobiliary & Pancreatic Diseases International》2025年第2期164-169,共6页国际肝胆胰疾病杂志(英文版)

基　　金：supported by grants from the National Nat-ural Science Foundation of China(82173129);the Innova-tive and Entrepreneurial Talent Doctor of Jiangsu Province,China(JSSCBS20221872)。

摘　　要：Background:Dorsal approach is the potentially effective strategy for minimally invasive liver resection.This study aimed to compare the outcomes between robot-assisted and laparoscopic hemihepatectomy through dorsal approach.Methods:We compared the patients who underwent robot-assisted hemihepatectomy(Rob-HH)and who had laparoscopic hemihepatectomy(Lap-HH)through dorsal approach between January 2020 and December 2022.A 1:1 propensity score-matching(PSM)analysis was performed to minimize bias and confounding factors.Results:Ninety-six patients were included,41 with Rob-HH and 55 with Lap-HH.Among them,58 underwent left hemihepatectomy(LHH)and 38 underwent right hemihepatectomy(RHH).Compared with LapHH group,patients with Rob-HH had less estimated blood loss(median:100.0 vs.300.0 m L,P=0.016),lower blood transfusion rates(4.9%vs.29.1%,P=0.003)and postoperative complication rates(26.8%vs.54.5%,P=0.016).These significant differences consistently existed after PSM and in the LHH subgroups.Furthermore,robot-assisted LHH was associated with decreased Pringle duration(45 vs.60 min,P=0.047).RHH subgroup analysis showed that compared with Lap-RHH,Rob-RHH was associated with less estimated blood loss(200.0 vs.400.0 m L,P=0.013).No significant differences were found in other perioperative outcomes among pre-and post-PSM cohorts,such as Pringle duration,operative time,and hospital stay.Conclusions:The dorsal approach was a safe and feasible strategy for hemi-hepatectomy with favorable outcomes under robot-assisted system in reducing intraoperative blood loss,transfusion,and postoperative complications.

关 键 词：Dorsal approach Robot-assisted system LAPAROSCOPY Anatomic hepatectomy Propensity score-matched 

分 类 号：R657.3[医药卫生—外科学]