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Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data

Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data
Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data
Background: the role of laparoscopy for major hepatectomies remains a matter of development to be further assessed. The purpose of this study is to compare the short- and long-term outcomes between laparoscopic and open major hepatectomies meta-analyzing individual patient data from published comparative studies.

Methods: all retrospective studies comparing between laparoscopic and open major hepatectomies published until March 2017 were identified independently by 2 reviewers by searching in PubMed and Cochrane Central Register of Controlled Trials. Individual patient data were sought from all selected studies. Postoperative outcomes, including intraoperative blood loss, operative time, hospital stay, postoperative complications, mortality rates, and long-term survival were analyzed.

Results: a total of 917 patients were divided into the laparoscopic (427) and open (490) groups from 8 selected studies. The hospital stay was significantly shorter, and the total morbidity was lower in the laparoscopic group. When classified by severity, the incidence of postoperative minor complications was lower; however, that of major complications was not significantly different. The operative time was longer in the laparoscopic group; however, intraoperative blood loss, perioperative mortality, and blood transfusions were comparable between the 2 groups. The overall survival in the patients with colorectal liver metastases and hepatocellular carcinoma was not significantly different between the 2 groups.

Conclusion: laparoscopic major hepatectomies offer some perioperative advantages, including fewer complications and shorter hospital stay, without increasing the blood loss volume and mortality. Whether these results can anticipate the outcomes in future randomized controlled trials has not been determined.
Journal Article, Review
0039-6060
985-995
Kasai, Meidai
a49395b6-f2bc-4750-a00a-dfffbf6512f7
Cipriani, Federica
aca25573-d300-425d-ba9c-20be3190ce2e
Gayet, Brice
576fd706-862f-4204-89d9-80f52fa3afa6
Aldrighetti, Luca
bab36581-c535-4f90-970d-0a982fe7a244
Ratti, Francesca
6ee4b291-99b0-48c7-b983-6f0f9e14d90d
Sarmiento, Juan M
82526663-2e31-447f-9129-1fbbc563db03
Scatton, Olivier
55755db5-b254-4dfb-a6d7-b4dfd652747b
Kim, Ki-Hun
0a82e50b-522a-430c-90fa-7f7c8d9440d8
Dagher, Ibrahim
312c6f59-9764-45d0-a050-cb27a3100f23
Topal, Baki
5e8bbea3-d28c-4408-a124-681471fa6482
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Nomi, Takeo
f3a3d820-d0b5-4fb9-ba6b-378a1a2efa1f
Fuks, David
8136736e-aa17-490c-8d7f-86ccd7b25906
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47
Kasai, Meidai
a49395b6-f2bc-4750-a00a-dfffbf6512f7
Cipriani, Federica
aca25573-d300-425d-ba9c-20be3190ce2e
Gayet, Brice
576fd706-862f-4204-89d9-80f52fa3afa6
Aldrighetti, Luca
bab36581-c535-4f90-970d-0a982fe7a244
Ratti, Francesca
6ee4b291-99b0-48c7-b983-6f0f9e14d90d
Sarmiento, Juan M
82526663-2e31-447f-9129-1fbbc563db03
Scatton, Olivier
55755db5-b254-4dfb-a6d7-b4dfd652747b
Kim, Ki-Hun
0a82e50b-522a-430c-90fa-7f7c8d9440d8
Dagher, Ibrahim
312c6f59-9764-45d0-a050-cb27a3100f23
Topal, Baki
5e8bbea3-d28c-4408-a124-681471fa6482
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Nomi, Takeo
f3a3d820-d0b5-4fb9-ba6b-378a1a2efa1f
Fuks, David
8136736e-aa17-490c-8d7f-86ccd7b25906
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47

Kasai, Meidai, Cipriani, Federica, Gayet, Brice, Aldrighetti, Luca, Ratti, Francesca, Sarmiento, Juan M, Scatton, Olivier, Kim, Ki-Hun, Dagher, Ibrahim, Topal, Baki, Primrose, John, Nomi, Takeo, Fuks, David and Abu Hilal, Mohammad (2018) Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery, 163 (5), 985-995. (doi:10.1016/j.surg.2018.01.020).

Record type: Review

Abstract

Background: the role of laparoscopy for major hepatectomies remains a matter of development to be further assessed. The purpose of this study is to compare the short- and long-term outcomes between laparoscopic and open major hepatectomies meta-analyzing individual patient data from published comparative studies.

Methods: all retrospective studies comparing between laparoscopic and open major hepatectomies published until March 2017 were identified independently by 2 reviewers by searching in PubMed and Cochrane Central Register of Controlled Trials. Individual patient data were sought from all selected studies. Postoperative outcomes, including intraoperative blood loss, operative time, hospital stay, postoperative complications, mortality rates, and long-term survival were analyzed.

Results: a total of 917 patients were divided into the laparoscopic (427) and open (490) groups from 8 selected studies. The hospital stay was significantly shorter, and the total morbidity was lower in the laparoscopic group. When classified by severity, the incidence of postoperative minor complications was lower; however, that of major complications was not significantly different. The operative time was longer in the laparoscopic group; however, intraoperative blood loss, perioperative mortality, and blood transfusions were comparable between the 2 groups. The overall survival in the patients with colorectal liver metastases and hepatocellular carcinoma was not significantly different between the 2 groups.

Conclusion: laparoscopic major hepatectomies offer some perioperative advantages, including fewer complications and shorter hospital stay, without increasing the blood loss volume and mortality. Whether these results can anticipate the outcomes in future randomized controlled trials has not been determined.

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Accepted/In Press date: 31 January 2018
e-pub ahead of print date: 16 March 2018
Published date: 1 May 2018
Additional Information: Copyright © 2018 Elsevier Inc. All rights reserved.
Keywords: Journal Article, Review

Identifiers

Local EPrints ID: 420570
URI: https://eprints.soton.ac.uk/id/eprint/420570
ISSN: 0039-6060
PURE UUID: 1610dfc7-3f8b-4cb9-8bc9-50b22d0a7d37
ORCID for John Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 10 May 2018 16:30
Last modified: 29 May 2019 04:01

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Contributors

Author: Meidai Kasai
Author: Federica Cipriani
Author: Brice Gayet
Author: Luca Aldrighetti
Author: Francesca Ratti
Author: Juan M Sarmiento
Author: Olivier Scatton
Author: Ki-Hun Kim
Author: Ibrahim Dagher
Author: Baki Topal
Author: John Primrose ORCID iD
Author: Takeo Nomi
Author: David Fuks
Author: Mohammad Abu Hilal

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