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British Journal of Surgery
Article . 2017 . Peer-reviewed
License: OUP Standard Publication Reuse
Data sources: Crossref
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Outcome after laparoscopic and open resections of posterosuperior segments of the liver

Authors: Scuderi V.; Barkhatov L.; Montalti R.; Ratti F.; Cipriani F.; Pardo F.; Tranchart H.; +7 Authors

Outcome after laparoscopic and open resections of posterosuperior segments of the liver

Abstract

Abstract Background Laparoscopic resection of posterosuperior (PS) segments of the liver is hindered by limited visualization and curvilinear resection planes. The aim of this study was to compare outcomes after open and laparoscopic liver resections of PS segments. Methods Patients who underwent minor open liver resection (OLR) and laparoscopic liver resection (LLR) between 2006 and 2014 were identified from the institutional databases of seven tertiary referral European hepatobiliary surgical units. Propensity score-matched analysis was used to match groups for known confounders. Perioperative outcomes including complications were assessed using the Dindo–Clavien classification, and the comprehensive complication index was calculated. Survival was analysed with the Kaplan–Meier method. Results Some 170 patients underwent OLR and 148 had LLR. After propensity score-matched analysis, 86 patients remained in both groups. Overall postoperative complication rates were significantly higher after OLR compared with LLR: 28 versus 14 per cent respectively (P = 0·039). The mean(s.d.) comprehensive complication index was higher in the OLR group, although the difference was not statistically significant (26·7(16·6) versus 18·3(8·0) in the LLR group; P = 0·108). The mean(s.d.) duration of required analgesia and the median (range) duration of postoperative hospital stay were significantly shorter in the LLR group: 3·0(1·1) days versus 1·6(0·8) days in the OLR group (P < 0·001), and 6 (3–44) versus 4 (1–11) days (P < 0·001), respectively. The 3-year recurrence-free survival rates for patients with hepatocellular carcinoma (37 per cent for OLRversus 30 per cent for LLR; P = 0·534) and those with colorectal liver metastases (36 versus 36 per cent respectively; P = 0·440) were not significantly different between the groups. Conclusion LLR of tumours in PS segments is feasible in selected patients. LLR is associated with fewer complications and does not compromise survival compared with OLR.

Country
Italy
Keywords

Adult, Male, Carcinoma, Hepatocellular, Adolescent, Operative Time, Young Adult, Postoperative Complications, Adolescent; Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular; Feasibility Studies; Female; Humans; Laparoscopy; Length of Stay; Liver Neoplasms; Male; Middle Aged; Operative Time; Postoperative Care; Postoperative Complications; Propensity Score; Retrospective Studies; Young Adult, 80 and over, Humans, Propensity Score, Aged, Retrospective Studies, Aged, 80 and over, Postoperative Care, Carcinoma, Liver Neoplasms, Hepatocellular, Length of Stay, Middle Aged, Feasibility Studies, Female, Laparoscopy

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    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    87
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 1%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 1%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
87
Top 1%
Top 10%
Top 1%
hybrid