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. 2020 Sep;15(3):395-402.
doi: 10.5114/wiitm.2020.94268. Epub 2020 Apr 7.

Laparoscopic versus open liver resections of posterolateral liver segments - a systematic review and meta-analysis

Mateusz Rubinkiewicz  1 , Magdalena Mizera  1 , Piotr Małczak  1 , Natalia Gajewska  1 , Grzegorz Torbicz  1 , Michael Su  2 , Konrad Karcz  3 , Michał Pędziwiatr  1
Affiliations

Laparoscopic versus open liver resections of posterolateral liver segments - a systematic review and meta-analysis

Mateusz Rubinkiewicz et al. Wideochir Inne Tech Maloinwazyjne. 2020 Sep.

Abstract

Introduction: Laparoscopic resection has become an accepted approach to liver tumour surgery. However, it is considered difficult, especially in unfavourably located lesions.

Aim: To compare the outcomes of laparoscopic (LLR) and open liver resection (OLR) of posterolateral segments.

Material and methods: We searched the PubMed, EMBASE, and Scopus databases from inception to 30 September 2019. Full text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines.

Results: From 643 articles, 15 studies (N = 1196 patients) were included in the meta-analysis. All of them were non-randomised. Our findings showed that LLR had significantly lowered overall morbidity compared to OLR (MD = 0.66; 95% CI: 0.51-0.86; p = 0.002). Length of hospital stay (MD = 2.48; 95% CI: -3.87, -1.08; p < 0.001) was also shorter in the LLR group. Operative time (MD = 55.65; 95% CI: 24.14-87.16; p < 0.001) was significantly shorter in the OLR group. In terms of blood loss, major complications, R0 resection rates, and resection margin, there were no significant differences.

Conclusions: Our meta-analysis showed that the laparoscopic approach to resections of posterolateral liver segments is beneficial. However, the results are based on non-randomised trials, and further research is needed to fully establish their clinical application.

Keywords: hepatectomy; laparoscopy; liver neoplasms; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart
Figure 2
Figure 2
Overall morbidity CI – confidence interval, df – degrees of freedom, M-H – Mantel-Haenszel.
Figure 3
Figure 3
Major complications CI – confidence interval, df – degrees of freedom, M-H – Mantel-Haenszel.
Figure 4
Figure 4
Operative time CI – confidence interval, df – degrees of freedom, IV – inverse variance.
Figure 5
Figure 5
Intraoperative blood loss CI – confidence interval, df – degrees of freedom, IV – inverse variance.
Figure 6
Figure 6
Resection margin CI – confidence interval, df – degrees of freedom, IV – inverse variance.
Figure 7
Figure 7
Non-R0 resections CI – confidence interval, df – degrees of freedom, M-H – Mantel-Haenszel.
Figure 8
Figure 8
Length of hospital stay CI – confidence interval, df – degrees of freedom, IV – inverse variance.
See this image and copyright information in PMC

References

    1. Małczak P, Mizera M, Torbicz G, et al. Is the laparoscopic approach for rectal cancer superior to open surgery? A systematic review and meta-analysis on short-term surgical outcomes. Videosurgery Miniinv. 2018;13:129–40. - PMC - PubMed
    1. Pędziwiatr M, Małczak P, Mizera M, et al. Pancreatoduodenectomy for pancreatic head tumors in the elderly – systematic review and meta-analysis. Surg Oncol. 2018;27:346–64. - PubMed
    1. Bonjer HJ, Deijen CL, Abis GA, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372:1324–32. - PubMed
    1. Hackl C, Schlitt HJ, Renner P, Lang SA. Liver surgery in cirrhosis and portal hypertension. World J Gastroenterol. 2016;22:2725–35. - PMC - PubMed
    1. Kanematsu T, Takenaka K, Matsumata T, et al. Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg. 1984;199:51–6. - PMC - PubMed