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Article: Propensity score-matched analysis of laparoscopic-assisted and hand-assisted laparoscopic liver resection versus pure laparoscopic liver resection: an international multicenter study

TitlePropensity score-matched analysis of laparoscopic-assisted and hand-assisted laparoscopic liver resection versus pure laparoscopic liver resection: an international multicenter study
Authors
KeywordsHand-assisted
Hybrid
Laparoscopic liver resection
Laparoscopic-assisted
Liver
Minimal-invasive
Oncology
Issue Date1-Jul-2023
PublisherSpringer
Citation
Surgical Endoscopy, 2023, v. 37, n. 7, p. 5482-5493 How to Cite?
Abstract

Background

Laparoscopic-assisted (LALR) and hand-assisted (HALR) liver resections have been utilized during the early adoption phase by surgeons when transitioning from open surgery to pure LLR. To date, there are limited data reporting on the outcomes of LALR or HALR compared to LLR. The objective was to compare the perioperative outcomes after LALR and HALR versus pure LLR.

Methods

This is an international multicentric analysis of 6609 patients undergoing minimal-invasive liver resection at 21 centers between 2004 and 2019. Perioperative outcomes were analyzed after propensity score matching (PSM) comparison between LALR and HALR versus LLR.

Results

5279 cases met study criteria of whom 5033 underwent LLR (95.3%), 146 underwent LALR (2.8%) and 100 underwent HALR (1.9%). After 1:4 PSM, LALR was associated with inferior outcomes as evidenced by the longer postoperative stay, higher readmission rate, higher major morbidity rate and higher in-hospital mortality rate. Similarly, 1:6 PSM comparison between HALR and LLR also demonstrated poorer outcomes associated with HALR as demonstrated by the higher open conversion rate and higher blood transfusion rate. All 3 approaches technical variants demonstrated the same oncological radicality (R1 rate).

Conclusion

LALR and HALR performed during the learning curve was associated with inferior perioperative outcomes compared to pure LLR.


Persistent Identifierhttp://hdl.handle.net/10722/339445
ISSN
2023 Impact Factor: 2.4
2023 SCImago Journal Rankings: 1.120
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKrenzien, Felix-
dc.contributor.authorSchmelzle, Moritz-
dc.contributor.authorPratschke, Johann-
dc.contributor.authorSyn, Nicholas L-
dc.contributor.authorSucandy, Iswanto-
dc.contributor.authorChiow, Adrian K H-
dc.contributor.authorMarino, Marco V-
dc.contributor.authorGastaca, Mikel-
dc.contributor.authorWang, Xiaoying-
dc.contributor.authorLee, Jae Hoon-
dc.contributor.authorChong, Charing C-
dc.contributor.authorFuks, David-
dc.contributor.authorChoi, Gi Hong-
dc.contributor.authorEfanov, Mikhail-
dc.contributor.authorKingham, T Peter-
dc.contributor.authorD’Hondt, Mathieu-
dc.contributor.authorTroisi, Roberto I-
dc.contributor.authorChoi, Sung Hoon-
dc.contributor.authorSutcliffe, Robert P-
dc.contributor.authorLiu, Rong-
dc.contributor.authorCheung, Tan-To-
dc.contributor.authorTang, Chung Ngai-
dc.contributor.authorHan, Ho-Seong-
dc.contributor.authorGoh, Brian K P-
dc.contributor.authorChan, Chung-Yip-
dc.contributor.authorD’Silva, Mizelle-
dc.contributor.authorSchotte, Henri-
dc.contributor.authorde Meyere, Celine-
dc.contributor.authorLai, Eric C H-
dc.contributor.authorKadam, Prashant-
dc.contributor.authorMontalti, Roberto-
dc.contributor.authorLiu, Qu-
dc.contributor.authorLee, Kit Fai-
dc.contributor.authorSalimgereeva, Diana-
dc.contributor.authorAlikhanov, Ruslan-
dc.contributor.authorLee, Lip Seng-
dc.contributor.authorPrieto, Mikel-
dc.contributor.authorJang, Jae Young -
dc.date.accessioned2024-03-11T10:36:40Z-
dc.date.available2024-03-11T10:36:40Z-
dc.date.issued2023-07-01-
dc.identifier.citationSurgical Endoscopy, 2023, v. 37, n. 7, p. 5482-5493-
dc.identifier.issn0930-2794-
dc.identifier.urihttp://hdl.handle.net/10722/339445-
dc.description.abstract<h3>Background</h3><p>Laparoscopic-assisted (LALR) and hand-assisted (HALR) liver resections have been utilized during the early adoption phase by surgeons when transitioning from open surgery to pure LLR. To date, there are limited data reporting on the outcomes of LALR or HALR compared to LLR. The objective was to compare the perioperative outcomes after LALR and HALR versus pure LLR.</p><h3>Methods</h3><p>This is an international multicentric analysis of 6609 patients undergoing minimal-invasive liver resection at 21 centers between 2004 and 2019. Perioperative outcomes were analyzed after propensity score matching (PSM) comparison between LALR and HALR versus LLR.</p><h3>Results</h3><p>5279 cases met study criteria of whom 5033 underwent LLR (95.3%), 146 underwent LALR (2.8%) and 100 underwent HALR (1.9%). After 1:4 PSM, LALR was associated with inferior outcomes as evidenced by the longer postoperative stay, higher readmission rate, higher major morbidity rate and higher in-hospital mortality rate. Similarly, 1:6 PSM comparison between HALR and LLR also demonstrated poorer outcomes associated with HALR as demonstrated by the higher open conversion rate and higher blood transfusion rate. All 3 approaches technical variants demonstrated the same oncological radicality (R1 rate).</p><h3>Conclusion</h3><p>LALR and HALR performed during the learning curve was associated with inferior perioperative outcomes compared to pure LLR.</p>-
dc.languageeng-
dc.publisherSpringer-
dc.relation.ispartofSurgical Endoscopy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectHand-assisted-
dc.subjectHybrid-
dc.subjectLaparoscopic liver resection-
dc.subjectLaparoscopic-assisted-
dc.subjectLiver-
dc.subjectMinimal-invasive-
dc.subjectOncology-
dc.titlePropensity score-matched analysis of laparoscopic-assisted and hand-assisted laparoscopic liver resection versus pure laparoscopic liver resection: an international multicenter study-
dc.typeArticle-
dc.identifier.doi10.1007/s00464-023-10028-7-
dc.identifier.scopuseid_2-s2.0-85152575170-
dc.identifier.volume37-
dc.identifier.issue7-
dc.identifier.spage5482-
dc.identifier.epage5493-
dc.identifier.eissn1432-2218-
dc.identifier.isiWOS:000973639200003-
dc.identifier.issnl0930-2794-

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