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

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2024-10-19 DOI:10.1002/rcs.70003

Daisuke Fukumori, Christoph Tschuor, Takashi Hamada, Nicolai Aagaard Schultz, Paul Suno Krohn, Stefan Burgdorf, Luit Penninga, Jan Henrik Storkholm, Christian Ross Pedersen, Jens Hillingsø, Lars Bo Svendsen, Peter Nørgaard Larsen

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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.

Abstract Image

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机器人肝脏手术后的短期疗效：丹麦高容量中心与传统开放式肝脏手术的倾向分数匹配分析

背景本研究的目的是在一个手术量较大的中心调查机器人肝脏手术（RLS）和开放式肝脏手术（OLS）的围术期疗效。方法对RLS和OLS的回顾性数据库进行了1:1倾向得分匹配（PSM）分析。进行累积总和（CUSUM）分析以确定学习曲线。结果经过 PSM 分析，RLS 组的手术时间明显更长（p < 0.001）。RLS 组的估计失血量明显更少（p < 0.001）。RLS 组的输血率明显较低。RLS 组的住院时间更短（3.5 对 6.3 天，p < 0.001）。RLS 组的再入院率明显较低（p < 0.049）。CUSUM 分析显示，至少有 8 例低级-中级 RLS 手术和 27 例高级-专家级 RLS 手术存在学习曲线。结论与 OLS 相比，RLS 有很多优点，包括操作安全、失血少、术后恢复快。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.