Laparoscopic liver resection in elderly patients: systematic review and meta-analysis

Notarnicola, Margherita; Felli, Emanuele; Roselli, S.; Altomare, Donato F.; Fazio, Michele De; de’Angelis, Nicola; Piardi, Tullio; Acquafredda, Silvana; Ammendola, Michele; Verbo, Alessandro; Pessaux, Patrick; Méméo, Riccardo

doi:10.1007/s00464-019-06840-9

Cited by 20 publications

(14 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are in accordance with the results of the OSLO-COMET RCT that demonstrated the superiority of laparoscopic liver resection for mCRC [68], and supports the use of laparoscopy also in selected older patients. Moreover, they corroborate the findings of a recent meta-analysis that evaluated the outcomes of all types of laparoscopic liver resection (for both benign and malignant lesions) in older patients, and reported significantly better intra-operative (e.g., bleeding) and postoperative outcomes (e.g., severe Dindo-Clavien complications) for laparoscopy vs. open surgery [69]. It must be noted that the surgical approach chosen may have a relevant impact on postoperative outcomes, PLOS ONE especially in a higher-risk patient population such as older patients.…”

Section: Discussionsupporting

confidence: 85%

Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis

et al. 2020

Self Cite

View full text Add to dashboard Cite

The present study explored the existing literature to describe the outcomes of surgical and regional treatments for colorectal cancer metastases (mCRC) in older patients. Methods A literature search was conducted in PubMed, EMBASE, Cochrane and ClinicalTrials.gov for studies published since 2000 that investigated the short-and long-term outcomes of regional treatments (surgical or non-surgical) for mCRC in patients aged �65 years. Pooled data analyses were conducted by calculating the risk ratio (RR), mean differences (MD) and hazard ratio (HR) between older and younger patients or between two different approaches in older patients. Results After screening 266 articles, 29 were included in this review. These studies reported the outcomes of surgery (n = 19) and non-surgical local ablation treatments (n = 3) for CRC metastases in older vs. younger patients or compared the outcomes of different interventions in

show abstract

Section: Discussionsupporting

confidence: 85%

Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The role of laparoscopic approach in the management of HCC in elderly patients remains uncertain. Limited data in terms of oncological outcome and long-term survival has been reported in this population [18][19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Defining the role of laparoscopic liver resection in elderly HCC patients - a propensity score matched analysis

Wong¹

2021

View full text Add to dashboard Cite

Aim: To elucidate the role and efficacy of laparoscopic liver resection for elderly patients with hepatocellular carcinoma (HCC).Methods: A retrospective comparative analysis was performed between laparoscopic and open liver resection operated from year 2008 to 2018. Consecutive HCC patients aged 65 or above at the time of operation were recruited. Patients with recurrent HCC and/or alternative pathology were excluded. Short-term and long-term outcomes between the laparoscopic and the open group were compared. Propensity score matching of patients in a ratio of 1:2 was conducted before comparison.Results: A total of 911 patients underwent hepatectomy for primary HCC from 2008 to 2018. Among them, 320 elderly patients aged over 65 years old were eligible for analysis. Heterogeneities between laparoscopic and open groups were identified namely pre-operative albumin level, aspartate transaminase, and magnitude of hepatectomy (major vs. minor). After propensity score matching of 1:2, 46 patients in the laparoscopic group and 92 patients in the open group were included for comparison. The laparoscopic group had less blood loss (326 mL vs. 735 mL; P < 0.001), shorter operative time (223 min vs. 324 min; P < 0.001), and shorter hospital stay (6.3 days vs. 10.5 days; P < 0.001). No significant differences in postoperative morbidity and hospital mortality were noted between the groups. For oncological outcome, the laparoscopic group had a superior disease-free survival (59.7% vs. 44.5%; P = 0.041), and a trend towards better overall survival compared with the open group. (78.4% vs. 64.8%; P = 0.110). Conclusion:Laparoscopic liver resection is a safe approach for elderly patients with HCC with benefits from faster recovery and better oncological outcomes.

show abstract

“…Many studies have reported that LLR showed improved surgical and postoperative outcomes. 6,13,[20][21][22] With these evidences, the indications for LLR have been expanded to malignancies and major hepatectomies, and further studies have proven the safety and acceptable morbidity and mortality rates of LLR. Also, advancements in postoperative care and improvements in laparoscopic instruments have made LLR more feasible for the treatment of neoplastic liver disease.…”

Section: Discussionmentioning

confidence: 99%

“…Recent LLR studies in elderly patients also reported similar results for cardiopulmonary and renal complications. 5,20,25,26 The absence of large abdominal incisions in the LLR group, which resulted in less postoperative pain and the preservation of pulmonary function, might have counterbalanced the adverse effects of pneumoperitoneum and less blood loss might have been a counterpart of the risk of renal injury in the LLR group. 27 Consistent with recent studies, our study showed the non-inferiority, or even the superiority of LLR compared to OLR in terms of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Short-Term Outcomes between Laparoscopic and Open Liver Resection in Elderly Patients

Lee

Yun

et al. 2020

J Minim Invasive Surg

View full text Add to dashboard Cite

Purpose The aim of this study was to compare the short-term outcomes between laparoscopic liver resection (LLR) and open liver resection (OLR) in elderly patients with hepatic tumors. Methods From January 2013 to December 2019, a retrospective study was conducted for a total of 143 patients with over 70 years of age, who underwent liver resection for hepatic tumors. Forty-five patients who received biliary reconstruction at the same time were excluded. According to surgical approaches, 98 patients were classified into LLR and OLR groups. All postoperative complications were classified according to the Clavien-Dindo grading system and the Comprehensive Complication Index (CCI). Results Incidence of the postoperative complications was not statistically different between LLR and OLR groups. The CCI was significantly lower in the LLR group, with a median of 8.556, and a median of 19.698 in the OLR group ( p =0.042). The length of hospital stay in the LLR group was significantly shorter than in the OLR group ( p =0.008). Conclusion LLR is safe and feasible as a treatment for hepatic tumor in elderly patients with potentially less postoperative complications compared to OLR.

show abstract

Laparoscopic liver resection in elderly patients: systematic review and meta-analysis

Cited by 20 publications

References 31 publications

Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis

Surgical and regional treatments for colorectal cancer metastases in older patients: A systematic review and meta-analysis

Defining the role of laparoscopic liver resection in elderly HCC patients - a propensity score matched analysis

A Comparison of Short-Term Outcomes between Laparoscopic and Open Liver Resection in Elderly Patients

Contact Info

Product

Resources

About