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Article: Comparison between minimally invasive right anterior and right posterior sectionectomy vs right hepatectomy: an international multicenter propensity score-matched and coarsened-exact-matched analysis of 1,100 patients
Title | Comparison between minimally invasive right anterior and right posterior sectionectomy vs right hepatectomy: an international multicenter propensity score-matched and coarsened-exact-matched analysis of 1,100 patients |
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Authors | Willems, EdwardD'hondt, MathieuKingham, T PeterFuks, DavidChoi, Gi-HongSyn, Nicholas LSucandy, IswantoMarino, Marco VPrieto, MikelChong, Charing CLee, Jae HoonEfanov, MikhailChiow, Adrian K HChoi, Sung HoonSutcliffe, Robert PTroisi, Roberto IPratschke, JohannCheung, Tan-ToWang, XiaoyingTang, Chung-NgaiLiu, RongHan, Ho-SeongGoh, Brian K P |
Issue Date | 15-Nov-2022 |
Publisher | Lippincott, Williams & Wilkins |
Citation | Journal of The American College of Surgeons, 2022, v. 235, n. 6, p. 859-868 How to Cite? |
Abstract | BACKGROUND: The role of minimally invasive right anterior and right posterior sectionectomy (MI-RAS/MI-RPS) for right-sided liver lesions remains debatable. Although technically more demanding, these procedures might result in faster recovery and lower postoperative morbidity compared with minimally invasive right hemihepatectomy. STUDY DESIGN: This is an international multicenter retrospective analysis of 1,114 patients undergoing minimally invasive right hemihepatectomy, MI-RAS, and MI-RPS at 21 centers between 2006 and 2019. Minimally invasive surgery included pure laparoscopic, robotic, hand-assisted, or a hybrid approach. A propensity-matched and coarsened-exact-matched analysis was performed. RESULTS: A total of 1,100 cases met study criteria, of whom 759 underwent laparoscopic, 283 robotic, 11 hand-assisted, and 47 laparoscopic-assisted (hybrid) surgery. There were 632 right hemihepatectomies, 373 right posterior sectionectomies, and 95 right anterior sectionectomies. There were no differences in baseline characteristics after matching. In the MI-RAS/MI-RPS group, median blood loss was higher (400 vs 300 mL, p = 0.001) as well as intraoperative blood transfusion rate (19.6% vs 10.7%, p = 0.004). However, the overall morbidity rate was lower including major morbidity (7.1% vs 14.3%, p = 0.007) and reoperation rate (1.4% vs 4.6%, p = 0.029). The rate of close/involved margins was higher in the MI-RAS/MI-RPS group (23.4% vs 8.9%, p < 0.001). These findings were consistent after both propensity and coarsened-exact matching. CONCLUSIONS: Although technically more demanding, MI-RAS/MI-RPS is a valuable alternative for minimally invasive right hemihepatectomy in right-sided liver lesions with lower postoperative morbidity, possibly due to the preservation of parenchyma. However, the rate of close/involved margins is higher in these procedures. These findings might guide surgeons in preoperative counselling and in selecting the appropriate procedure for their patients. |
Persistent Identifier | http://hdl.handle.net/10722/338788 |
ISSN | 2023 Impact Factor: 3.8 2023 SCImago Journal Rankings: 1.419 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Willems, Edward | - |
dc.contributor.author | D'hondt, Mathieu | - |
dc.contributor.author | Kingham, T Peter | - |
dc.contributor.author | Fuks, David | - |
dc.contributor.author | Choi, Gi-Hong | - |
dc.contributor.author | Syn, Nicholas L | - |
dc.contributor.author | Sucandy, Iswanto | - |
dc.contributor.author | Marino, Marco V | - |
dc.contributor.author | Prieto, Mikel | - |
dc.contributor.author | Chong, Charing C | - |
dc.contributor.author | Lee, Jae Hoon | - |
dc.contributor.author | Efanov, Mikhail | - |
dc.contributor.author | Chiow, Adrian K H | - |
dc.contributor.author | Choi, Sung Hoon | - |
dc.contributor.author | Sutcliffe, Robert P | - |
dc.contributor.author | Troisi, Roberto I | - |
dc.contributor.author | Pratschke, Johann | - |
dc.contributor.author | Cheung, Tan-To | - |
dc.contributor.author | Wang, Xiaoying | - |
dc.contributor.author | Tang, Chung-Ngai | - |
dc.contributor.author | Liu, Rong | - |
dc.contributor.author | Han, Ho-Seong | - |
dc.contributor.author | Goh, Brian K P | - |
dc.date.accessioned | 2024-03-11T10:31:32Z | - |
dc.date.available | 2024-03-11T10:31:32Z | - |
dc.date.issued | 2022-11-15 | - |
dc.identifier.citation | Journal of The American College of Surgeons, 2022, v. 235, n. 6, p. 859-868 | - |
dc.identifier.issn | 1072-7515 | - |
dc.identifier.uri | http://hdl.handle.net/10722/338788 | - |
dc.description.abstract | <p> <span>BACKGROUND: The role of minimally invasive right anterior and right posterior sectionectomy (MI-RAS/MI-RPS) for right-sided liver lesions remains debatable. Although technically more demanding, these procedures might result in faster recovery and lower postoperative morbidity compared with minimally invasive right hemihepatectomy. STUDY DESIGN: This is an international multicenter retrospective analysis of 1,114 patients undergoing minimally invasive right hemihepatectomy, MI-RAS, and MI-RPS at 21 centers between 2006 and 2019. Minimally invasive surgery included pure laparoscopic, robotic, hand-assisted, or a hybrid approach. A propensity-matched and coarsened-exact-matched analysis was performed. RESULTS: A total of 1,100 cases met study criteria, of whom 759 underwent laparoscopic, 283 robotic, 11 hand-assisted, and 47 laparoscopic-assisted (hybrid) surgery. There were 632 right hemihepatectomies, 373 right posterior sectionectomies, and 95 right anterior sectionectomies. There were no differences in baseline characteristics after matching. In the MI-RAS/MI-RPS group, median blood loss was higher (400 vs 300 mL, p = 0.001) as well as intraoperative blood transfusion rate (19.6% vs 10.7%, p = 0.004). However, the overall morbidity rate was lower including major morbidity (7.1% vs 14.3%, p = 0.007) and reoperation rate (1.4% vs 4.6%, p = 0.029). The rate of close/involved margins was higher in the MI-RAS/MI-RPS group (23.4% vs 8.9%, p < 0.001). These findings were consistent after both propensity and coarsened-exact matching. CONCLUSIONS: Although technically more demanding, MI-RAS/MI-RPS is a valuable alternative for minimally invasive right hemihepatectomy in right-sided liver lesions with lower postoperative morbidity, possibly due to the preservation of parenchyma. However, the rate of close/involved margins is higher in these procedures. These findings might guide surgeons in preoperative counselling and in selecting the appropriate procedure for their patients.</span> <br></p> | - |
dc.language | eng | - |
dc.publisher | Lippincott, Williams & Wilkins | - |
dc.relation.ispartof | Journal of The American College of Surgeons | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | Comparison between minimally invasive right anterior and right posterior sectionectomy vs right hepatectomy: an international multicenter propensity score-matched and coarsened-exact-matched analysis of 1,100 patients | - |
dc.type | Article | - |
dc.identifier.doi | 10.1097/XCS.0000000000000394 | - |
dc.identifier.scopus | eid_2-s2.0-85142400785 | - |
dc.identifier.volume | 235 | - |
dc.identifier.issue | 6 | - |
dc.identifier.spage | 859 | - |
dc.identifier.epage | 868 | - |
dc.identifier.isi | WOS:000885371100009 | - |
dc.identifier.issnl | 1072-7515 | - |