دورية أكاديمية

Laparoscopic versus open right posterior sectionectomy: an international, multicenter, propensity score-matched evaluation

التفاصيل البيبلوغرافية
العنوان: Laparoscopic versus open right posterior sectionectomy: an international, multicenter, propensity score-matched evaluation
المؤلفون: van der Heijde N., Ratti F., Aldrighetti L., Benedetti Cacciaguerra A., Can M. F., D'Hondt M., Di Benedetto F., Ivanecz A., Magistri P., Menon K., Papoulas M., Vivarelli M., Besselink M. G., Abu Hilal M.
المساهمون: van der Heijde, N., Ratti, F., Aldrighetti, L., Benedetti Cacciaguerra, A., Can, M. F., D'Hondt, M., Di Benedetto, F., Ivanecz, A., Magistri, P., Menon, K., Papoulas, M., Vivarelli, M., Besselink, M. G., Abu Hilal, M.
سنة النشر: 2021
المجموعة: Archivio della ricerca dell'Università di Modena e Reggio Emilia (Unimore: IRIS)
مصطلحات موضوعية: Laparoscopic surgery, Liver surgery, Minimally invasive surgery, Operative outcome, Propensity score matching, Surgical procedure
الوصف: Background: Although laparoscopic liver resection has become the standard for minor resections, evidence is lacking for more complex resections such as the right posterior sectionectomy (RPS). We aimed to compare surgical outcomes between laparoscopic (LRPS) and open right posterior sectionectomy (ORPS). Methods: An international multicenter retrospective study comparing patients undergoing LRPS or ORPS (January 2007—December 2018) was performed. Patients were matched based on propensity scores in a 1:1 ratio. Primary endpoint was major complication rate defined as Accordion ≥ 3 grade. Secondary endpoints included blood loss, length of hospital stay (LOS) and resection status. A sensitivity analysis was done excluding the first 10 LRPS patients of each center to correct for the learning curve. Additionally, possible risk factors were explored for operative time, blood loss and LOS. Results: Overall, 399 patients were included from 9 centers from 6 European countries of which 150 LRPS could be matched to 150 ORPS. LRPS was associated with a shorter operative time [235 (195–285) vs. 247min (195–315) p = 0.004], less blood loss [260 (188–400) vs. 400mL (280–550) p = 0.009] and a shorter LOS [5 (4–7) vs. 8days (6–10), p = 0.002]. Major complication rate [n = 8 (5.3%) vs. n = 9 (6.0%) p = 1.00] and R0 resection rate [144 (96.0%) vs. 141 (94.0%), p = 0.607] did not differ between LRPS and ORPS, respectively. The sensitivity analysis showed similar findings in the previous mentioned outcomes. In multivariable regression analysis blood loss was significantly associated with the open approach, higher ASA classification and malignancy as diagnosis. For LOS this was the open approach and a malignancy. Conclusion: This international multicenter propensity score-matched study showed an advantage in favor of LRPS in selected patients as compared to ORPS in terms of operative time, blood loss and LOS without differences in major complications and R0 resection rate.
نوع الوثيقة: article in journal/newspaper
اللغة: English
العلاقة: info:eu-repo/semantics/altIdentifier/pmid/33140153; info:eu-repo/semantics/altIdentifier/wos/WOS:000584333800009; volume:35; issue:11; firstpage:6139; lastpage:6149; journal:SURGICAL ENDOSCOPY; http://hdl.handle.net/11380/1220882Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85094835653
DOI: 10.1007/s00464-020-08109-y
الإتاحة: https://doi.org/10.1007/s00464-020-08109-yTest
http://hdl.handle.net/11380/1220882Test
حقوق: info:eu-repo/semantics/openAccess
رقم الانضمام: edsbas.8EF3ABEF
قاعدة البيانات: BASE