Minimally Invasive vs. Open Hepatectomy: a Comparative Analysis of the National Surgical Quality Improvement Program Database

Fabio Bagante, Gaya Spolverato, Steven M. Strasberg, Faiz Gani, Vanessa Thompson, Bruce L. Hall, David J. Bentrem, Henry A. Pitt, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: While minimally invasive surgery (MIS) to treat liver tumors has increased, data on perioperative outcomes of MIS relative to open liver resection (O-LR) are lacking. We sought to compare short-term outcomes among patients undergoing MIS vs. O-LR in a nationally representative database. Methods: The National Surgical Quality Improvement Program database was used to identify patients undergoing hepatectomy between January 1 and December 31, 2014. Propensity score matching algorithm was used to balance differences in baseline characteristics among MIS and O-LR groups. Results: A total of 3064 patients were included in the study. After propensity matching, the baseline characteristics for O-LR and MIS groups were comparable (minimum p value = 0.12). Incidence of superficial surgical site infections, intraoperative or postoperative blood transfusions, and pulmonary embolism was lower among patients in MIS group compared to O-LR (p < 0.02). Liver failure and biliary leakage were also less frequent among patients undergoing MIS (p < 0.01). Similarly, MIS was associated with a shorter length of hospital stay (LOS) compared to O-LR (p < 0.001). Of note, 30-day postoperative mortality and readmission were comparable between the two groups. Conclusions: Patients undergoing MIS had a lower postoperative morbidity and shorter LOS compared with patients undergoing O-LR. MIS is safe and may be associated with improved short-term outcomes following hepatic surgery.

Original languageEnglish
Pages (from-to)1608-1617
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume20
Issue number9
DOIs
StatePublished - Sep 1 2016

Keywords

  • Laparoscopic surgery
  • Liver surgery
  • Minimally invasive surgery
  • Robotic surgery

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