AUTHOR=Yang Jun , Li Enliang , Wang Cong , Luo Shuaiwu , Fu Zixuan , Peng Jiandong , Liao Wenjun , Wu Linquan 

TITLE=Robotic versus open extended cholecystectomy for T1a–T3 gallbladder cancer: A matched comparison

JOURNAL=Frontiers in Surgery

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2022.1039828

DOI=10.3389/fsurg.2022.1039828

ISSN=2296-875X

ABSTRACT=<sec><title>Background</title><p>The feasibility and safety of robotic extended cholecystectomy (REC) are still uncertain. This study was performed to compare the short- and long-term outcomes of REC with those of open extended cholecystectomy (OEC) for T1a–T3 gallbladder cancer.</p></sec><sec><title>Methods</title><p>From January 2015 to April 2022, 28 patients underwent REC in our center. To minimize any confounding factors, a 1:2 propensity score-matching analysis was conducted based on the patients’ demographics, liver function indicators, T stage, and symptoms. The data regarding demographics, perioperative outcomes, and long-term oncologic outcomes were reviewed.</p></sec><sec><title>Results</title><p>The visual analogue scale score was significantly lower in the REC than OEC group immediately postoperatively (3.68 ± 2.09 vs. 4.73 ± 1.85, <italic>P</italic> = 0.008), on postoperative day 1 (2.96 ± 1.75 vs. 3.69 ± 1.41, <italic>P</italic> = 0.023), and on postoperative day 2 (2.36 ± 1.55 vs. 2.92 ± 1.21, <italic>P</italic> = 0.031). In addition, the REC group exhibited a shorter time to first ambulation (<italic>P</italic> = 0.043), a shorter time to drainage tube removal (<italic>P</italic> = 0.038), and a shorter postoperative stay (<italic>P</italic> = 0.037), but hospital costs were significantly higher in the REC group (<italic>P</italic> &lt; 0.001). However, no statistically significant difference was found in the operation time (<italic>P</italic> = 0.134), intraoperative blood loss (<italic>P</italic> = 0.467), or incidence of postoperative morbidity (<italic>P</italic> = 0.227) or mortality (<italic>P</italic> = 0.289) between the REC and OEC groups. In regard to long-term outcomes, the 3-year disease-free survival rate was comparable between the OEC and REC groups (43.1% vs. 57.2%, <italic>P</italic> = 0.684), as was the 3-year overall survival rate (62.8% vs. 75.0%, <italic>P</italic> = 0.619).</p></sec><sec><title>Conclusion</title><p>REC can be an effective and safe alternative to OEC for selected patients with T1a–T3 gallbladder cancer with respect to short- and long-term outcomes.</p></sec>