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

• DOI: 10.1016/j.heliyon.2024.e24800
• Publication Date: 2024-01-21T09:27:11Z
• Authors: Aldo Rocca; Pasquale Avella; Andrea Scacchi; Maria Chiara Brunese; Micaela Cappuccio; Michele De Rosa; Alberto Bartoli; Germano Guerra; Fulvio Calise; Graziano Ceccarelli
• Keywords: Colorectal liver metastases; Social sciences (General); H1-99; Open liver surgery; Q1-390; Science (General); Hub and spoke program; Colorectal liver metastases; Hub and spoke program; Learning program; Open liver surgery; Robotic liver resection; Robotic liver resection; Learning program; Research Article

BackgroundSurgical resection is the best treatment for colorectal liver metastasis (CRLM). Although laparoscopic and robotic surgery demonstrated their reliability especially in referral centers, comparison between perioperative outcomes of (RLR) open (OLR) still debate considering resections performed centers surgery, but not dedicated to HPB. Our study aimed verify efficacy safety after RLR OLR CRLM an HUB&Spoke learning program (H&S) high volume center surgery.MethodsWe analyzed prospective databases Pineta Grande Hospital (Castel Volturno), A. Cardarelli (Campobasso) Robotic Surgical Units (Foligno-Spoleto Arezzo) from 2011 2021. A 1:1 propensity score matching (PSM) was according baseline characteristics patients, solitary/multiple CRLM, anterolateral/posterosuperior location.Results383 patients accepted be part (268 ORL 115 RLR). After PSM, 45 each group were included. Conversion rate 8.89 %. had a significantly lower blood loss (226 vs. 321 ml; p=0.0001), fewer major complications (13.33 % 17.78 %; p=0.7722). R0 obtained 100 (vs. 95.55 %). stay 8.8 days 15; p=0.0001). Conclusion: H&S represents safe effective train general surgeons also Hepatobiliary providing rate, morbidity superimposable centers. Furthermore, allow reduction health mobility with consequent money saving institutions.