Meta-analysis of laparoscopic<i>vs</i>open liver resection for hepatocellular carcinoma

Xiong, Junjie; Altaf, Kiran; Javed, Muhammad Ahsan; Huang, Wei; Mukherjee, Rajarshi; Mai, Gang; Sutton, Robert; Liu, Xu-Bao; Hu, Weiming

doi:10.3748/wjg.v18.i45.6657

Cited by 150 publications

(111 citation statements)

References 46 publications

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“…The results of the ongoing multicenter Orange-II trials assessing open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery ERAS program may provide further evidence [55]. Twelve other systematic reviews were identified [56][57][58][59][60][61][62][63][64][65][66][67], 9 included meta-analysis comparing open versus laparoscopic liver surgery [58][59][60][62][63][64][65][66][67]. These meta-analyses concluded that LLR was associated with lower intraoperative blood loss, blood transfusion, postoperative complications and shorter hospital stay.…”

Section: Minimally Invasive Approachmentioning

confidence: 99%

“…These meta-analyses concluded that LLR was associated with lower intraoperative blood loss, blood transfusion, postoperative complications and shorter hospital stay. In addition, LLR reduced the incidence of liver failure and lowered postoperative ileus, while decreasing overall cost [60,63,68]. Moreover, it seems that patients with LLR had a faster oral intake and required less intravenous narcotic use [66].…”

Section: Minimally Invasive Approachmentioning

confidence: 99%

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Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Minimally Invasive Approachmentioning

confidence: 99%

Section: Minimally Invasive Approachmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…Studies from other centers showed similar advantages (7)(8)(9)(10)(11). In the western literature, indication of liver resection was greatly governed by the Barcelona Clinic Liver Cancer classification (12).…”

Section: Am Writing In Response To Professor Taizo Hibi's Editorialmentioning

confidence: 88%

Laparoscopic liver resection in patients with liver cirrhosis—the path towards standard of care

Cheung

2018

Hepatobiliary Surg. Nutr.

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“…Furthermore, these were found to be lower after LLR in 40 and 11 studies, respectively. Twelve meta-analyses and one Cochrane report were also analyzed [35][36][37][38][39][40][41][42][43][44][45][46][47] and consistent results included reduced blood loss and transfusions requirements when studied. This clearly shows that, in selected patients LLR when compared with open surgery is associated with reduced blood loss and subsequent transfusion rates.…”

Section: Discussionmentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

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Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

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Meta-analysis of laparoscopicvsopen liver resection for hepatocellular carcinoma

Abstract: LLR appears to be a safe and feasible option for resection of HCC in selected patients based on current evidence. However, further appropriately designed randomized controlled trials should be undertaken to ascertain these findings.

Cited by 150 publications

References 46 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Laparoscopic liver resection in patients with liver cirrhosis—the path towards standard of care

Bleeding control during laparoscopic liver resection: a review of literature

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