Comparing Perioperative Outcomes of Robotic-Assisted Versus Laparoscopic Liver Resection in Patients with Hepatocellular Carcinoma.

: Despite the implementation of laparoscopic and robotic-assisted liver resection (LLR vs. RLR) in many centers, there remains controversy surrounding the differences in perioperative outcomes between the two approaches. This study aims to clarify the discrepancies in perioperative outcomes between LLR and RLR through a prospective study. Patients with HCC received LLR or RLR were included. The postoperative complications were categorized and evaluated employing the standardized Clavien-Dindo classification and the Comprehensive Complication Index (CCI) score. Specifically, the median CCI of 20.9 was set as the cut-off value for the occurrence of severe complications. A 1:2 propensity score matched (PSM) analysis was performed to control confounding bias. A total of 273 patients were included, of whom 213 (78%) patients received LLR and 60 (22%) patients received RLR. After PSM, RLR was associated with a longer operative time but shorter hospital stays (all P < 0.05). Postoperative outcomes in terms of overall complications, major and minor complications, and mortality were similar between RLR and LLR groups (all P > 0.05). Of note, RLR is significantly associated with a lower CCI score, especially server complications (OR 0.826, 95%CI 0.386-0.883, P = 0.023). In terms of complication rates, RLR does not reduce the incidence of overall complications when compared to LLR, but it can reduce the severity of complications that occur. RLR, is a feasible and safe approach for patients with HCC.