Comparison of laparoscopic versus open liver resection for lesions located in posterosuperior segments: a meta-analysis of short-term and oncological outcomes
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The role of laparoscopic liver resection (LLR) for lesions located in posterosuperior (PS) segments remains a matter of development to be further assessed. This systematic review aims to compare the short-term and oncological outcomes between laparoscopic and open liver resection (OLR) in PS lesions.
EMBASE, MEDLINE and Cochrane Library were searched from date of inception to June 2019. This meta-analysis was performed using the STATA 12.0 statistical software. Standardized mean differences (SMDs), odds ratios (ORs) and hazard ratios (HRs) were calculated for continuous variables, dichotomous variables and long-term variables, respectively, with 95% confidence intervals (CIs).
A total of 788 patients from eight studies were identified for the final analysis, with 371 patients in the LLR group and 417 in the OLR group. Although the operation time (SMD 0.22; 95% CI 0.08–0.36; P = 0.003) was longer whereas overall complication rate (OR 0.50; 95% CI 0.36–0.70; P < 0.001) and postoperative hospital stay (SMD − 0.45; 95% CI − 0.59 to − 0.30; P = 0.003) were lower in the LLR group than in the OLR group, no significant differences in blood loss (SMD − 0.14; 95% CI − 0.28 to 0.00; P = 0.054), transfusion rate (OR 0.92; 95% CI 0.56–1.54; P = 0.764), major complication rate (OR 0.63; 95% CI 0.38–1.05; P = 0.079), R0 resection rate (OR 1.04; 95% CI 0.55–1.96; P = 0.902), and disease-free survival (DFS) for hepatocellular carcinoma (HCC) (HR 1.43; 95% CI 0.95–2.17), DFS for colorectal liver metastases (HR 1.05; 95% CI 0.61–1.81), overall survival for HCC (HR 1.00; 95% CI 0.43–2.30) were noted between the groups.
LLR is technically feasible and safe without compromising long-term oncological outcomes for selected patients with lesions in the PS segments of the liver.
KeywordsLaparoscopic liver resection Posterosuperior segments Caudal approach
Compliance with ethical standards
The authors Huan Zheng, Shao Gang Huang, Shu Min Qin and Fei Xiang have no conflicts of interest or financial ties to disclose.
- 1.Gagner M (1992) Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 6:97–98Google Scholar
- 5.Kasai M, Cipriani F, Gayet B, Aldrighetti L, Ratti F, Sarmiento JM, Scatton O, Kim KH, Dagher I, Topal B, Primrose J, Nomi T, Fuks D, Abu Hilal M (2018) Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery 163:985–995CrossRefGoogle Scholar
- 9.Scuderi V, Barkhatov L, Montalti R, Ratti F, Cipriani F, Pardo F, Tranchart H, Dagher I, Rotellar F, Abu Hilal M, Edwin B, Vivarelli M, Aldrighetti L, Troisi RI (2017) Outcome after laparoscopic and open resections of posterosuperior segments of the liver. Br J Surg 104:751–759CrossRefGoogle Scholar
- 10.D’Hondt M, Tamby E, Boscart I, Turcotte S, Parmentier I, Pottel H, Lapointe R, Ovaere S, Vansteenkiste F, Vandenbroucke-Menu F (2018) Laparoscopic versus open parenchymal preserving liver resections in the posterosuperior segments: a case-matched study. Surg Endosc 32:1478–1485CrossRefGoogle Scholar
- 13.Okuno M, Goumard C, Mizuno T, Omichi K, Tzeng CD, Chun YS, Aloia TA, Fleming JB, Lee JE, Vauthey JN, Conrad C (2018) Operative and short-term oncologic outcomes of laparoscopic versus open liver resection for colorectal liver metastases located in the posterosuperior liver: a propensity score matching analysis. Surg Endosc 32:1776–1786CrossRefGoogle Scholar
- 14.Morikawa T, Ishida M, Takadate T, Aoki T, Ohtsuka H, Mizuma M, Hayashi H, Nakagawa K, Motoi F, Naitoh T, Unno M (2019) Laparoscopic partial liver resection improves the short-term outcomes compared to open surgery for liver tumors in the posterosuperior segments. Surg Today 49:214–223CrossRefGoogle Scholar
- 15.Aghayan DL, Fretland AA, Kazaryan AM, Sahakyan MA, Dagenborg VJ, Bjornbeth BA, Flatmark K, Kristiansen R, Edwin B (2019) Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial. HPB. https://doi.org/10.1016/j.hpb.2019.03.358 CrossRefPubMedGoogle Scholar
- 22.Gold JS, Are C, Kornprat P, Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Blumgart LH, D’Angelica M (2008) Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome: trends in treatment over time in 440 patients. Ann Surg 247:109–117CrossRefGoogle Scholar
- 25.Ciria R, Gomez-Luque I, Ocana S, Cipriani F, Halls M, Briceno J, Okuda Y, Troisi R, Rotellar F, Soubrane O, Abu Hilal M (2019) A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for hepatocellular carcinoma: updated results from the european guidelines meeting on laparoscopic liver surgery, Southampton, UK, 2017. Ann Surg Oncol 26:252–263CrossRefGoogle Scholar
- 30.Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830CrossRefGoogle Scholar