Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes
Background: Surgical resection is still considered the optimal treatment for colorectal liver metastasis (CRLM). Although laparoscopic and robotic surgery demonstrated their reliability especially in referral centers, the comparison between perioperative outcomes of robotic liver resection (RLR) and...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-02-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024008314 |
| _version_ | 1797304574376148992 |
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| author | Aldo Rocca Pasquale Avella Andrea Scacchi Maria Chiara Brunese Micaela Cappuccio Michele De Rosa Alberto Bartoli Germano Guerra Fulvio Calise Graziano Ceccarelli |
| author_facet | Aldo Rocca Pasquale Avella Andrea Scacchi Maria Chiara Brunese Micaela Cappuccio Michele De Rosa Alberto Bartoli Germano Guerra Fulvio Calise Graziano Ceccarelli |
| author_sort | Aldo Rocca |
| collection | DOAJ |
| description | Background: Surgical resection is still considered the optimal treatment for colorectal liver metastasis (CRLM). Although laparoscopic and robotic surgery demonstrated their reliability especially in referral centers, the comparison between perioperative outcomes of robotic liver resection (RLR) and open (OLR) liver resection are still debated when performed in referral centers for robotic surgery, not dedicated to HPB. Our study aimed to verify the efficacy and safety of perioperative outcomes after RLR and OLR for CRLM in an HUB&Spoke learning program (H&S) between a high volume center for liver surgery and high volume center for robotic surgery. Methods: We analyzed prospective databases of Pineta Grande Hospital (Castel Volturno) and Robotic Surgical Units (Foligno-Spoleto and Arezzo) from 2011 to 2021. A 1:1 propensity score matching (PSM) was performed according to baseline characteristics of patients, solitary/multiple CRLM, anterolateral/posterosuperior location. Results: 383 patients accepted to be part of the study (268 ORL and 115 RLR). After PSM, 45 patients from each group were included. Conversion rate was 8.89 %. RLR group had a significantly lower blood loss (226 vs. 321 ml; p=0.0001), and fewer major complications (13.33 % vs. 17.78 %; p=0.7722). R0 resection was obtained in 100% of OLR (vs. 95.55%, p =0.4944. Hospital stay was 8.8 days in RLR (vs. 15; p=0.0001).Conclusion: H&S represents a safe and effective program to train general surgeons also in Hepatobiliary surgery providing R0 resection rate, blood loss volume and morbidity rate superimposable to referral centers. Furthermore, H&S allow a reduction of health mobility with consequent money saving for patients and institutions. |
| first_indexed | 2024-03-08T00:12:23Z |
| format | Article |
| id | doaj.art-b1ce0572b1174f65b63663ec5ab845ea |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T00:12:23Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-b1ce0572b1174f65b63663ec5ab845ea2024-02-17T06:38:41ZengElsevierHeliyon2405-84402024-02-01103e24800Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomesAldo Rocca0Pasquale Avella1Andrea Scacchi2Maria Chiara Brunese3Micaela Cappuccio4Michele De Rosa5Alberto Bartoli6Germano Guerra7Fulvio Calise8Graziano Ceccarelli9Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy; Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy; Corresponding author. Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy.Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, Italy; Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy; Corresponding author. Department of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy.General Surgery Department, University of Milano-Bicocca, Milan, ItalyDepartment of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, ItalyDepartment of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, ItalyGeneral Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, ItalyGeneral Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, ItalyDepartment of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, ItalyDepartment of Medicine and Health Science “V. Tiberio”, University of Molise, Campobasso, Italy; Hepatobiliary and Pancreatic Surgery Unit, Pineta Grande Hospital, Castel Volturno, Caserta, ItalyGeneral Surgery Department, ASL 2 Umbria, San Giovanni Battista Hospital, Foligno, ItalyBackground: Surgical resection is still considered the optimal treatment for colorectal liver metastasis (CRLM). Although laparoscopic and robotic surgery demonstrated their reliability especially in referral centers, the comparison between perioperative outcomes of robotic liver resection (RLR) and open (OLR) liver resection are still debated when performed in referral centers for robotic surgery, not dedicated to HPB. Our study aimed to verify the efficacy and safety of perioperative outcomes after RLR and OLR for CRLM in an HUB&Spoke learning program (H&S) between a high volume center for liver surgery and high volume center for robotic surgery. Methods: We analyzed prospective databases of Pineta Grande Hospital (Castel Volturno) and Robotic Surgical Units (Foligno-Spoleto and Arezzo) from 2011 to 2021. A 1:1 propensity score matching (PSM) was performed according to baseline characteristics of patients, solitary/multiple CRLM, anterolateral/posterosuperior location. Results: 383 patients accepted to be part of the study (268 ORL and 115 RLR). After PSM, 45 patients from each group were included. Conversion rate was 8.89 %. RLR group had a significantly lower blood loss (226 vs. 321 ml; p=0.0001), and fewer major complications (13.33 % vs. 17.78 %; p=0.7722). R0 resection was obtained in 100% of OLR (vs. 95.55%, p =0.4944. Hospital stay was 8.8 days in RLR (vs. 15; p=0.0001).Conclusion: H&S represents a safe and effective program to train general surgeons also in Hepatobiliary surgery providing R0 resection rate, blood loss volume and morbidity rate superimposable to referral centers. Furthermore, H&S allow a reduction of health mobility with consequent money saving for patients and institutions.http://www.sciencedirect.com/science/article/pii/S2405844024008314Colorectal liver metastasesOpen liver surgeryRobotic liver resectionHub and spoke programLearning program |
| spellingShingle | Aldo Rocca Pasquale Avella Andrea Scacchi Maria Chiara Brunese Micaela Cappuccio Michele De Rosa Alberto Bartoli Germano Guerra Fulvio Calise Graziano Ceccarelli Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes Heliyon Colorectal liver metastases Open liver surgery Robotic liver resection Hub and spoke program Learning program |
| title | Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes |
| title_full | Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes |
| title_fullStr | Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes |
| title_full_unstemmed | Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes |
| title_short | Robotic versus open resection for colorectal liver metastases in a “referral centre Hub&Spoke learning program”. A multicenter propensity score matching analysis of perioperative outcomes |
| title_sort | robotic versus open resection for colorectal liver metastases in a referral centre hub spoke learning program a multicenter propensity score matching analysis of perioperative outcomes |
| topic | Colorectal liver metastases Open liver surgery Robotic liver resection Hub and spoke program Learning program |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024008314 |
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