Short-term outcomes of robotic versus open hepatectomy among overweight patients with hepatocellular carcinoma: a propensity score-matched study

BMC Surgery

Research

Guo-Dong Zhao¹  Cheng-Gang Li¹  Zhao-Hai Wang¹  Zhao-Yi Lin¹  Rong Liu¹  Xiu-Ping Zhang¹  Ming-Gen Hu² 

[1] Medical School of Chinese PLA, 100853, Beijing, China;Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, 100853, Beijing, China;Medical School of Chinese PLA, 100853, Beijing, China;Faculty of Hepato-Pancreato-Biliary Surgery, The First Medical Center of Chinese PLA General Hospital, 100853, Beijing, China;Department of Hepatobiliary, Pancreatic Surgical Oncology, The First Medical Center of Chinese PLA General Hospital, 100853, Beijing, China;

关键词: Hepatocellular carcinoma;    Overweight;    Robotic hepatectomy;    Open hepatectomy;    Outcome;   

DOI  :  10.1186/s12893-023-02058-8

 received in 2023-03-05, accepted in 2023-05-26,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundRobotic hepatectomy (RH) has gradually been accepted as it has overcome some of the limitations of open hepatectomy (OH). This study was to compare short-term outcomes in RH and OH for overweight (preoperative body mass index ≥ 25 kg/m²) patients with hepatocellular carcinoma (HCC).MethodsPerioperative and postoperative data from these patients who underwent RH or OH between January 2010 and December 2020 were retrospectively analyzed. Propensity score matching (PSM) analysis was performed to determine the impact of RH versus OH on the prognosis of overweight HCC patients.ResultsAll 304 overweight HCC patients were included, 172 who were underwent RH, and 132 who were underwent OH. After the 1:1 PSM, there were 104 patients in both RH and OH groups. After PSM, the RH group of patients had a shorter operative time, less estimated blood loss (EBL), a longer total clamping time, a shorter postoperative length of stay (LOS), less chance of surgical site infection and less rates of blood transfusion (all P < 0.05) compared to the OH patients. The differences between operative time, EBL and LOS were more significant in obese patients. RH was found to be an independent protective factor of EBL ≥ 400ml relative to OH in overweight patients for the first time.ConclusionsRH was safe and feasible in overweight HCC patients. Compared with OH, RH has advantages in terms of operative time, EBL, postoperative LOS, and surgical site infection. Carefully selected overweight patients should be considered for RH.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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