Are Hybrid Liver Resections Truly Minimally Invasive? A Propensity Score Matching Analysis

Coelho, Fabrício Ferreira; Pirola, KrugerJaime Arthur; Birk, JeismannVagner; Marques, FonsecaGilton; Ferrari, M; Augusto, FerreiraLeandro; Cecconello, Ivan; HermanPaulo,

doi:10.1089/lap.2017.0074

Cited by 8 publications

(20 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, we did not find any significant difference in operative time for patients undergoing MIRH. This finding can be explained by the increased experience with MILR, showing that the learning curve was overcome and surgical steps have been standardized to entail a significant reduction in operative time [ 38 , 39 ]. In fact, were included in our study patients that underwent hepatectomy between 2013 and 2018, after overcome the learning curve with MILRs.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs) Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, overall morbidity or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe in experienced hands. Minimally invasive approach was associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

Duarte

Coelho

Valverde

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Abstract Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

show abstract

“…However, we did not nd any signi cant difference in operative time for patients undergoing MIRH. This nding can be explained by the increased experience with MILR, showing that the learning curve was overcome and surgical steps have been standardized to entail a signi cant reduction in operative time (38,39). In fact, were included in our study patients that underwent hepatectomy between 2013 and 2018, after overcome the learning curve with MILRs.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

Duarte

Coelho

Valverde

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods: Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results: During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P=0.01), lower rate of minor complications (13.5% vs. 35%, P=0.03) and larger resection margins (10 mm vs. 5 mm, P=0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P=0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, overall morbidity or perioperative mortality were observed. OS was similar between the groups (P=0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P=0.09) and liver metastasis (P=0.80). Conclusions: MIRHs are feasible and safe in experienced hands. Minimally invasive approach was associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

show abstract

Are Hybrid Liver Resections Truly Minimally Invasive? A Propensity Score Matching Analysis

Abstract: Hybrid resection has better perioperative results than the open approach and is similar to pure laparoscopy. The hybrid technique should be considered a minimally invasive approach.

Cited by 8 publications

References 37 publications

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

Contact Info

Product

Resources

About