Comparison of laparoscopic liver resection for lesions located in anterolateral and posterosuperior segments: a meta-analysis
- 292 Downloads
Laparoscopic liver resection (LLR) is mostly performed to treat benign lesions at easily accessible locations. With improvements in instruments and accumulation of experience, LLR has evolved to treat malignant tumors with major hepatectomy, even in less accessible locations, without compromising the principles of safety and oncology. The present meta-analysis aimed to compare the outcomes of LLR for lesions located in anterolateral (AL) (II, III, IVb, V, and VI) and posterosuperior (PS) (I, IVa, VII, and VIII) liver segments.
A comprehensive search was conducted to identify all eligible studies. This meta-analysis was performed using the STATA 12.0 statistical software. Standardized mean differences (SMDs) and odds ratios (ORs) were calculated for continuous variables and dichotomous variables, respectively, with 95% confidence intervals (CIs).
A total of 846 patients from five studies were identified for the final analysis, with 565 patients in the AL group and 281 in the PS group. Although the operation time (SMD −0.60; 95% CI −0.75 to −0.45; P = 0.000) and conversion rate (OR 0.40; 95% CI 0.24–0.67; P = 0.000) were lower and the resection margin was wider (SMD 0.2; 95% CI 0.03–0.37; P = 0.019) in the AL group than in the PS group, no significant differences in blood loss (SMD −0.29; 95% CI −0.68 to 0.09; P = 0.131), complication rate (OR 0.73; 95% CI 0.50–1.07; P = 0.103), hospital stay (SMD −0.53; 95% CI −1.16 to 0.11; P = 0.105), and tumor recurrence (OR 1.23; 95% CI 0.81–1.86; P = 0.334) were noted between the groups.
LLR is technically feasible and safe for selected patients with lesions in the PS segments of the liver.
KeywordsLaparoscopic liver resection Anterolateral Posterosuperior Meta-analysis
Compliance with ethical standards
The authors BenBo Zheng, Rongce Zhao, Xiaodong Li, and Bo Li declare no conflict of interest.
- 4.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, World Consensus Conference on Laparoscopic S (2009) The international position on laparoscopic liver surgery: the Louisville statement, 2008. Ann Surg 250:825–830CrossRefPubMedGoogle Scholar
- 11.Lee W, Han HS, Yoon YS, Cho JY, Choi Y, Shin HK, Jang JY, Choi H, Jang JS, Kwon SU (2016) Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: a case-matched analysis. Surgery 160(5):1219–1226CrossRefPubMedGoogle Scholar
- 12.Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMedGoogle Scholar
- 22.Dagher I, Gayet B, Tzanis D, Tranchart H, Fuks D, Soubrane O, Han HS, Kim KH, Cherqui D, O’Rourke N, Troisi RI, Aldrighetti L, Bjorn E, Abu Hilal M, Belli G, Kaneko H, Jarnagin WR, Lin C, Pekolj J, Buell JF, Wakabayashi G (2014) International experience for laparoscopic major liver resection. J Hepato Biliary Pancreat Sci 21:732–736CrossRefGoogle Scholar