Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients

Witowski, Jan; Rubinkiewicz, Mateusz; Mizera, Magdalena; Wysocki, Michał; Gajewska, Natalia; Sitkowski, Mateusz; Małczak, Piotr; Major, Piotr; Budzyński, Andrzej; Pędziwiatr, Michał

doi:10.1007/s00464-018-6431-6

Cited by 59 publications

(64 citation statements)

References 75 publications

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“…As being a minimally invasive surgery, LLR was reported with advantages compared with traditional operation, including less intraoperative blood loss, fewer complications, shorter hospital stays, and equivalent long-term outcomes. 12,13 Even many studies have been carried out to evaluate the outcomes of LLR in terms of age, body mass index (BMI), surgical position, surgical approaches, location of the tumor, size of the tumor, contact with major vessel, previously abdominal surgery history, liver cirrhosis, resection extent, surgical instrument and techniques, and learning curve. 9–11,14–17…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Laparoscopic Liver Resection for Patients with Multiple Hepatocellular Carcinomas Meeting the Milan Criteria: A Propensity Score-Matched Analysis

Peng

Liu

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: Until now, there is little knowledge about the value of laparoscopic liver resection (LLR) for patients with multiple hepatocellular carcinomas (HCC). This study was performed to assess the efficacy and outcomes of LLR versus open liver resection (OLR) for patients with multiple HCC meeting the Milan criteria.Methods: One hundred fifteen patients with multiple HCC meeting the Milan criteria who underwent liver resection from April 2015 to March 2018 were enrolled into this study. According to the different surgical procedures, patients were divided into LLR group and OLR group. Perioperative and oncological outcomes were compared between the two groups after propensity score matching (PSM) with 1:1 match.Results: Thirty three patients were included into each group after PSM with well-balanced basic level. The intraoperative blood loss in LLR group was less than OLR group before PSM (median, 200 vs. 300 mL, P = .004), but the difference was not statistically significant after PSM (median, 200 vs. 300 mL, P = .064). LLR group showed shorter postoperative hospital stay when compared with OLR group (median, 7 vs. 8 days, respectively, P = .014). The perioperative complications and early mortality were comparable in both groups. There were no significant differences in the term of overall survival (OS. P = .502) or recurrence-free survival (RFS. P = .887) between the two groups after PSM.Conclusions: LLR could be safely and feasibly performed for patients with multiple HCC meeting the Milan criteria in selected patients. It does not increase the risks of postoperative complications and has a similar oncological outcomes compared to OLR.

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Section: Introductionmentioning

confidence: 99%

Outcomes of Laparoscopic Liver Resection for Patients with Multiple Hepatocellular Carcinomas Meeting the Milan Criteria: A Propensity Score-Matched Analysis

Peng

Liu

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Another study noted five patients (13%) with postoperative complications after robotic liver surgery 7 . A meta-analysis showed 15.59% overall morbidity for laparoscopic liver surgery in hepatocellular carcinoma patients 37 .…”

Section: Discussionmentioning

confidence: 99%

A falciform ligament flap surface sealing technique for laparoscopic and robotic-assisted liver surgery

Rahimli

Perrakis

Schellerer

et al. 2020

Sci Rep

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Whether sealing the hepatic resection surface after liver surgery decreases morbidity is still unclear. Nevertheless, various methods and materials are currently in use for this procedure. Here, we describe our experience with a simple technique using a mobilized falciform ligament flap in minimally invasive liver surgery (MILS). We retrospectively analyzed the charts from 46 patients who received minor MILS between 2011 and 2019 from the same surgical team in a university hospital setting in Germany. Twenty-four patients underwent laparoscopic liver resection, and 22 patients received robotic-assisted liver resection. Sixteen patients in the laparoscopic group and fourteen in the robotic group received a falciform ligament flap (FLF) to cover the resection surface after liver surgery. Our cohort was thus divided into two groups: laparoscopic and robotic patients with (MILS + FLF) and without an FLF (MILS−FLF). Twenty-eight patients (60.9%) in our cohort were male. The overall mean age was 56.8 years (SD 16.8). The mean operating time was 249 min in the MILS + FLF group vs. 235 min in the MILS−FLF group (p = 0.682). The mean blood loss was 301 ml in the MILS + FLF group vs. 318 ml in the MILS−FLF group (p = 0.859). Overall morbidity was 3.3% in the MILS + FLF group vs. 18.8% in the MILS−FLF group (p = 0.114). One patient in the MILS−FLF group (overall 2.2%), who underwent robotic liver surgery, developed bile leakage, but this did not occur in the MILS + FLF group. Covering the resection surface of the liver after minor minimally invasive liver resection with an FLF is a simple and cost-effective technique that does not prolong surgical time or negatively affect other perioperative parameters. In fact, it is a safe add-on step during MILS that may reduce postoperative morbidity. Further studies with larger cohorts will be needed to substantiate our proof of concept and results.

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“…Nonetheless, meta-analyses considering all kinds of liver resections proved the laparoscopic approach to be both safe and efficient. Witowski et al included 43 studies with 5100 patients treated for hepatocellular carcinoma [6]. In their study, not only morbidity was reduced in the laparoscopic group, but the perioperative mortality was also comparable.…”

Section: Studymentioning

confidence: 99%

“…Despite the technical requirements, the laparoscopic approach proved to be a feasible method even for complex liver resections, surpassing an open approach in terms of reduced overall morbidity [6]. As an example, laparoscopic left sectionectomy has become a routine method; however, it is recommended only for experienced surgeons [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus open liver resections of posterolateral liver segments - a systematic review and meta-analysis.

Rubinkiewicz

Mizera

Małczak

et al. 2020

Videosurgery and Other Miniinvasive Techniques

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Introduction: Laparoscopic resection has become an accepted approach to liver tumour surgery. However, it is considered difficult, especially in unfavourably located lesions. Aim: To compare the outcomes of laparoscopic (LLR) and open liver resection (OLR) of posterolateral segments. Material and methods: We searched the PubMed, EMBASE, and Scopus databases from inception to 30 September 2019. Full text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines. Results: From 643 articles, 15 studies (N = 1196 patients) were included in the meta-analysis. All of them were non-randomised. Our findings showed that LLR had significantly lowered overall morbidity compared to OLR (

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Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients

Cited by 59 publications

References 75 publications

Outcomes of Laparoscopic Liver Resection for Patients with Multiple Hepatocellular Carcinomas Meeting the Milan Criteria: A Propensity Score-Matched Analysis

Outcomes of Laparoscopic Liver Resection for Patients with Multiple Hepatocellular Carcinomas Meeting the Milan Criteria: A Propensity Score-Matched Analysis

A falciform ligament flap surface sealing technique for laparoscopic and robotic-assisted liver surgery

Laparoscopic versus open liver resections of posterolateral liver segments - a systematic review and meta-analysis.

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