Clinical outcomes of minimally invasive (laparoscopic and robotic) versus open extended cholecystectomy: A multicenter propensity score matched study

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC ACS Applied Electronic Materials Pub Date : 2024-02-07 DOI:10.1002/jhbp.1419
Hee Ju Sohn, Mirang Lee, Youngmin Han, Wooil Kwon, Yoo-Seok Yoon, Ho-Seong Han, Chang Sup Lim, Jin-Young Jang
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Abstract

Background

This multicenter study aimed to compare the clinical outcomes of minimally invasive extended cholecystectomy (MI-EC) versus open EC (O-EC) for patients with gallbladder cancer (GBC).

Methods

Patients who underwent EC (cholecystectomy, wedge resection of the liver bed, and regional lymphadenectomy) for GBC between 2010 and 2020 in three centers were included in the study. The clinicopathological data were compared after propensity score matching. Additional subgroup analysis on laparoscopic and robotic EC (L-EC and R-EC) was performed.

Results

A total of 377 patients were included: 308 for O-EC and 69 for MI-EC, respectively. The MI-EC group had a longer operative time (188.9 vs. 238.1 min, p < .001) and shorter hospital stay (9.0 vs. 7.2 days, p = .007), although no differences were found in operative blood loss, complication rate and survival outcome. In subgroup analysis, L-EC patients had a longer operative time (264.4 vs. 202.0 min, p = .001), compared to R-EC patients with comparable perioperative and survival outcomes.

Conclusion

Although patients with MI-EC had a longer operation time and higher medical costs, the advantages were enhanced recovery with comparable short- and long-term outcomes. The operation time was less for R-EC patients than for L-EC patients, though the high cost still remains. The surgery type for EC can be selected according to the patient's condition, social status and surgeon's preference.

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微创(腹腔镜和机器人)与开腹扩大胆囊切除术的临床效果:一项多中心倾向评分匹配研究。
背景:这项多中心研究旨在比较微创扩大胆囊切除术(MI-EC)与开放式胆囊切除术(O-EC)对胆囊癌(GBC)患者的临床疗效:研究纳入了2010年至2020年间在三个中心接受胆囊切除术(胆囊切除术、肝床楔形切除术和区域淋巴结切除术)治疗GBC的患者。经过倾向评分匹配后,对临床病理数据进行了比较。此外,还对腹腔镜和机器人EC(L-EC和R-EC)进行了亚组分析:结果:共纳入377名患者:结果:共纳入377名患者:O-EC组308名,MI-EC组69名。MI-EC组的手术时间更长(188.9分钟对238.1分钟,P 结论:虽然MI-EC组患者的手术时间更长,但手术成功率更高:虽然 MI-EC 患者的手术时间更长,医疗费用更高,但其优点是恢复能力更强,短期和长期疗效相当。R-EC患者的手术时间比L-EC患者短,但费用仍然较高。心血管疾病的手术类型可根据患者的病情、社会地位和外科医生的偏好进行选择。
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CiteScore
7.20
自引率
4.30%
发文量
567
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