Safety of minimally invasive liver resections during live surgery: a propensity score based assessment

Background: Concerns regarding safety and outcomes of procedures performed during live events have been raised in the literature. Aim of the present investigation was to analyze the outcomes of laparoscopic liver resections performed during live events and conventional elective procedures. Methods: 60 laparoscopic liver resections performed during live events (Live group) were compared with 180 performed during conventional elective procedures (Control group) after propensity scores matching. The main endpoints were intraoperative and short-term postoperative outcomes. Results: Live and Control group had comparable blood loss (300 vs 350 mL, p NS) and conversion rate (13.3% vs 14.4%, p NS), despite longer operation time for patients in the Live Group (280 +/- 30 vs 210 +/- 20 min, p = 0.032). There were no differences in perioperative morbidity and mortality: severe complications respectively occurred in 2 patients of the Live and in 7 patients of the Control group (p NS) with none directly related to intraoperative accidents. Conclusions: In the setting of laparoscopic liver resections, live surgery does not negatively affect intra-and postoperative outcomes of patients if performed by expert surgeons: the creation of a specific expertise for the new generations of laparoscopic liver surgeons can be therefore pursued maintaining the primary endpoint of safety and oncological adequacy of procedures.