ArticleUpdates in surgery2025
Robotic vs laparoscopic resection for hepatocellular carcinoma: multicentric propensity-score matched analysis of surgical and oncologic outcomes in 647 patients.
Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Robotic hepatectomy for benign liver disease: single-centre consecutive series and meta-analysis comparing minimally invasive and open approaches.Journal of robotic surgery · 2026Pooled it
- Laparoscopic versus robotic surgery in the setting of combined resection of colorectal cancer and liver metastases: an experience from the I Go MILS registry.Updates in surgery · 2026Article
- Robotic versus laparoscopic surgery in hepatobiliary procedures: a scoping review.BMC surgery · 2026Article
- Comparative Outcomes of Minimally Invasive Surgical Approaches on Patient Recovery: A Systematic Review.Cureus · 2026Review
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29 authors.
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Abstract
BACKGROUND AND
objectivesLaparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) has been linked to several advantages compared to open approach, but the actual benefit of robotic liver resection (RLR) over LLR in HCC needs further investigation.
methodsWe performed a multicentric propensity-score matched (PSM) analysis comparing perioperative and oncologic outcomes of LLR vs. RLR for HCC. The PSM model was estimated using a multivariable logistic regression, with type of surgery as dependent variable and age, BMI, clinically-significant portal hypertension, αFP, size of principal lesion, number of nodules and Kawaguchi difficulty score as covariates. Overall (OS) and recurrence-free (RFS) survivals were estimated using the Kaplan-Meier method.
resultsSix-hundred-forty-seven HCC patients from 12 IGoMILS registry centers treated by LLR (553 patients) or RLR (94 patients) were included. After PSM, RLR resulted in wider surgical margins (median: 10 vs 5 mm; p = 0.002) with higher prevalence of R0 resection (98.9 vs 93.1%; p = 0.037), lower conversion rate (2.1 vs. 8.5%; p = 0.039) and shorter hospital stay (median: 4 vs 5 days; p = 0.025), with no significant difference in postoperative complication rate. We observed similar OS among RLR and LLR cohorts [5-y OS: 68.7 vs 65.0%; univariable HR = 0.95 (95% CI: 0.60-1.49); p = 0.82], with significantly better RFS in RLR cohort [5-y RFS: 46.8 vs 24.0%; univariable HR = 0.71 (95% CI: 0.52-0.98); p = 0.04].
conclusionsPerioperative outcomes were significantly better in the RLR cohort, with a lower conversion rate and shorter hospital stay, although the latter may be influenced by the multi-institutional study design. Notably, we observed wider resection margins in the RLR group, which were associated with significantly improved RFS.
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