The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments.

IF 6.1 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Hepatobiliary surgery and nutrition Pub Date : 2024-08-01 Epub Date: 2024-07-04 DOI:10.21037/hbsn-23-494

Jasper P Sijberden, Guido Fiorentini, Jacopo Lanari, Davit Aghayan, Daniel Osei-Bordom, Nadia Russolillo, Arjun Takhar, Andrea Benedetti Cacciaguerra, Santi Lopez-Ben, Mathieu D'Hondt, Felice Giuliante, David Fuks, Fernando Rotellar, Andrea Ruzzenente, Adnan Alseidi, Mikhail Efanov, Burak Görgec, Giuseppe Zimmitti, Enrico Gringeri, Federica Cipriani, Åsmund Avdem Fretland, Ravi Marudanayagam, Marco Vivarelli, John N Primrose, Alessandro Ferrero, Robert P Sutcliffe, Bjørn Edwin, Umberto Cillo, Marc G Besselink, Mohammad Abu Hilal, Luca A Aldrighetti

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引用次数: 0

Abstract

Background: It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected patients. However, what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus far. The aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral (AL) and posterosuperior (PS) segments.

Methods: In this international multicentre retrospective cohort study, laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score matching. The differential benefit of laparoscopy over open liver surgery, calculated using bootstrap sampling, was compared between AL and PS resections and expressed as a Delta of the differences.

Results: After matching, 3,040 AL and 2,336 PS resections were compared, encompassing open and laparoscopic procedures in a 1:1 ratio. AL and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss, transfusion rate, complications, and length of stay. However, AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications (D-difference were 4.8%, P=0.046 and 3%, P=0.046) and blood loss (D-difference was 195 mL, P<0.001). Similar results were observed in the subset for high-volume centres, while in recent years no significant differences were found in the differential benefit between AL and PS segments.

Conclusions: The advantage of laparoscopic over open liver surgery is greater in the AL segments than in the PS segments.

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对于位于前外侧或后上方的病变，腹腔镜小肝脏切除术与开腹小肝脏切除术的不同优势。

背景：众所周知，与开腹肝脏手术相比，腹腔镜肝脏手术在特定患者中更具优势。然而，迄今为止，对哪种类型的手术能从腹腔镜方法中获益最大的研究还不多。因此，本研究的目的是确定在前外侧（AL）和后上段（PS）病变的肝脏手术中，腹腔镜手术比开腹手术的优势程度：在这项国际多中心回顾性队列研究中，对AL和PS段病变的腹腔镜和开腹小肝脏切除术进行了倾向评分匹配比较。通过引导取样法计算出腹腔镜手术与开腹肝脏手术的不同获益，并在AL段和PS段切除术之间进行比较，以差异的Delta表示：结果：匹配后，比较了3,040例AL和2,336例PS切除术，其中开腹和腹腔镜手术的比例为1:1。就失血量、输血率、并发症和住院时间而言，腹腔镜肝切除术和腹腔镜肝切除术比开腹手术更有优势。然而，就总并发症和严重并发症（D-差值分别为4.8%，P=0.046和3%，P=0.046）以及失血量（D-差值为195毫升，PConclusions：与开腹肝脏手术相比，腹腔镜肝脏手术在AL段的优势大于PS段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hepatobiliary surgery and nutrition Multiple-

自引率

10.00%

发文量

392

期刊介绍： Hepatobiliary Surgery and Nutrition (HBSN) is a bi-monthly, open-access, peer-reviewed journal (Print ISSN: 2304-3881; Online ISSN: 2304-389X) since December 2012. The journal focuses on hepatopancreatobiliary disease and nutrition, aiming to present new findings and deliver up-to-date, practical information on diagnosis, prevention, and clinical investigations. Areas of interest cover surgical techniques, clinical and basic research, transplantation, therapies, NASH, NAFLD, targeted drugs, gut microbiota, metabolism, cancer immunity, genomics, and nutrition and dietetics. HBSN serves as a valuable resource for professionals seeking insights into diverse aspects of hepatobiliary surgery and nutrition.