A systematic review and meta-analysis of randomized controlled trials comparing laparoscopic and open liver resection

Haney, Caelán Max; Studier-Fischer, Alexander; Probst, Pascal; Fan, Carolyn; Müller, Philip; Golriz, Mohammad; Hackert, Thilo; Müller‐Stich, Beat P.; Mehrabi, Arianeb; Nickel, Felix

doi:10.1016/j.hpb.2021.03.006

Cited by 47 publications

(25 citation statements)

References 41 publications

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“…As already extensively discussed by Haney et al. in a recent review on laparoscopic versus open liver resections, the minimally invasive approach seemed to be safer for minor liver resections when performed in minimally invasive surgery 47 …”

Section: Discussionmentioning

confidence: 86%

“…In order to better understand the impact of our review in the HPB context we compared our results to other laparoscopic and open series reported in literature. [47][48][49][50]…”

Section: Resultsmentioning

confidence: 99%

“…As already extensively discussed by Haney et al in a recent review on laparoscopic versus open liver resections, the minimally invasive approach seemed to be safer for minor liver resections when performed in minimally invasive surgery. 47 Rahimli et al is the only author who clearly reported differences in peri-operative outcomes comparing minor to major RLRs. 28 Major/minor resections calculated on the total liver resections performed.…”

Section: Complicationsmentioning

confidence: 99%

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Robotic surgery for colorectal liver metastases resection: A systematic review

Rocca

Scacchi

Cappuccio

et al. 2021

Robotics Computer Surgery

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Background:The role of robotic surgery for colorectal cancer liver metastases (CRCLMs) has never been investigated in large series.Methods: A systematic literature review was carried out on PubMed and Cochrane libraries. Results:We selected nine studies between 2008 and 2021. Two hundred sixty-two patients were included. One hundred thirty-one patients underwent simultaneous resections. The mean blood loss was 309.4 ml (range, 200-450 ml), the mean operative time was 250.5 min (range, 198.5-449.0 min). The mean length of hospital stay was 7.98 days (range, 4.5 to 12 days). The overall postoperative mortality was 0.4%. The overall morbidity rate was 37.0%, Clavien-Dindo grade III-IV complications were 8.4%. The mean 3-year overall survival was 55.25% (range, 44.4-66.1%), the mean 3-year disease free survival was 37% (range, 33.3-41.9%) Conclusion:We can conclude that robotic-assisted surgery might be considered as a technical upgrade option for minimally invasive approach to CRCLM resections even for simultaneous operations and challenging cases.

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Section: Discussionmentioning

confidence: 86%

“…In order to better understand the impact of our review in the HPB context we compared our results to other laparoscopic and open series reported in literature. [47][48][49][50]…”

Section: Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

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Robotic surgery for colorectal liver metastases resection: A systematic review

Rocca

Scacchi

Cappuccio

et al. 2021

Robotics Computer Surgery

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“…PONV occurred in only three patients undergoing CSEA. The complications rate was low (Table 4) as reported in a large series [57][58][59].…”

Section: Discussionmentioning

confidence: 62%

Neuraxial anesthesia in hepato-pancreatic-bilio surgery: a first western pilot study of 46 patients

et al. 2023

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The most common anesthetic approach in hepato-pancreatic-biliary (HPB) surgery is general anesthesia (GA), but it may result in increased morbidity and mortality and peri-operative risks especially in frail patients. The aim of this study was to assess the safety and effectiveness of neuraxial anesthesia (NA) in HPB in a pilot clinical series. This analysis was conducted on 46 consecutive patients undergoing HPB surgery in an Italian Tertial referral center. Data were prospectively collected and retrospectively analyzed. continuous spinal anesthesia (CSA), combined spino-epidural anesthesia (CSEA) and peridural anesthesia (PA) were used in major and minor hepatectomies and bilio-pancreatic surgery instead of GA. NA was evaluated by analyzing the surgical and anesthesiological short-term outcomes. 46 patients were considered eligible for the study between February 2018 and May 2020. The average age was 69.07 (± 9.95) years. 22 were males and 24 were females. According to the ASA score, 19 (41.30%) patients had ASA II, 22 (47.83%) had ASA III and 5 (10.87%) had ASA IV. 22 (47.83%) patients underwent CSA, 20 (43.48%) CSEA and 4 (8.69%) PA. We performed 8 major and 19 minor hepatectomies, 7 bilio-digestive derivations, 5 Whipple procedures, 4 iatrogenic biliary duct injuries, 2 splenopancreatectomies and 1 hepatic cyst fenestration. Clavien-Dindo ≥ 3 was observed in 3 patients. The conversion rate to endotracheal intubation occurring in 3 of 46 (6.52%) patients. After surgery, no local or pulmonary complications and delirium were reported in our series. The present study demonstrates that NA is a safe and feasible option in selected patients, if performed in referral centers by well-trained anaesthesiologists and surgeons.

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“…Blood loss during laparoscopy is greatly reduced compared with that during open surgery ( 26 , 27 ). Through preoperative three-dimensional reconstruction and intraoperative ICG, the relationship between large blood vessels and tumors can be fully identified and the possibility of major bleeding can be reduced, thereby reducing intraoperative bleeding ( 28 ).…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green fluorescence-guided laparoscopic hepatectomy versus conventional laparoscopic hepatectomy for hepatocellular carcinoma: A single-center propensity score matching study

et al. 2022

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BackgroundIndocyanine green fluorescence-guided laparoscopic hepatectomy (ICG-guided LH) is increasingly used for the treatment of hepatocellular carcinoma (HCC). However, whether ICG-guided LH can improve surgical outcomes remains unclear. This study aimed to investigate the short-term outcomes and survival outcomes of ICG-guided LH versus common laparoscopic hepatectomy (CLH) for HCC.MethodsWe conducted a retrospective analysis of 104 ICG-guided LH and 158 CLH patients from 2014 to 2020 at our center. To avoid selection bias, 81 ICG-guided LH and 81 CLH cases were analyzed after 1:1 propensity score matching (PSM). The baseline data and results were compared between the two groups.ResultsThe baseline characteristics of both groups were comparable after matching. There was a significant difference in operative time: longer in the ICG-guided LH group than in the CLH group (p=0.004). However, there was no significant difference in operative time in anatomical resection between the two groups (p=0.987). There was a significant difference in operative time in non-anatomical resection: longer in the ICG-guided LH group than in the CLH group (p=0.001). There were no significant differences in positive surgery margin, blood loss, blood transfusion rate, postoperative complication rate, postoperative length of hospital stay, mortality within 30 days, and mortality within 90 days. The ICG-guided LH group appeared to have a trend towards better overall survival (OS), but there was no significant difference in OS (P=0.168) and recurrence-free survival (RFS) (P=0.322) between the two groups.ConclusionsAlthough ICG fluorescence-guided LH is a timelier procedure to perform, it is a safe and effective technique with the advantages of intraoperative positioning, low postoperative complication rates, and potential to improve OS.

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A systematic review and meta-analysis of randomized controlled trials comparing laparoscopic and open liver resection

Cited by 47 publications

References 41 publications

Robotic surgery for colorectal liver metastases resection: A systematic review

Robotic surgery for colorectal liver metastases resection: A systematic review

Neuraxial anesthesia in hepato-pancreatic-bilio surgery: a first western pilot study of 46 patients

Indocyanine green fluorescence-guided laparoscopic hepatectomy versus conventional laparoscopic hepatectomy for hepatocellular carcinoma: A single-center propensity score matching study

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