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Safety and feasibility for laparoscopic versus open caudate lobe resection: a meta-analysis

  • Systematic Reviews and Meta-analyses
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Abstract

Background

Laparoscopic hepatectomy has been used widely due to its advantages as a minimally invasive surgery. However, multicenter, large-scale, population-based laparoscopic caudate lobe resection (LCLR) versus open caudate lobe resection (OCLR) has rarely been reported. We assessed the feasibility and safety of LCLR compared with OCLR using meta-analysis.

Methods

Relevant literature was retrieved using PubMed, Embase, Cochrane, Ovid Medline, Web of Science, CNKI, and WanFang Med databases up to July 30th, 2020. Multiple parameters of feasibility and safety were compared between the treatment groups. Quality of studies was assessed with the Newcastle-Ottawa Scale (NOS). The data were analyzed by Review Manager 5.3. Results are expressed as odds ratio (OD) or mean difference (MD) with 95% confidence interval (95% CI) for fixed- and random-effects models.

Results

Seven studies with 237 patients were included in this meta-analysis. Compared with OCLR, the LCLR group had a lower intraoperative blood loss (MD − 180.84; 95% CI − 225.61 to − 136.07; P < 0.0001), shorter postoperative hospital stays (MD − 4.38; 95% CI − 7.07 to − 1.7; P = 0.001), shorter operative time (MD − 50.24; 95% CI − 78.57 to − 21.92; P = 0.0005), and lower rates in intraoperative blood transfusion (OR 0.12; P = 0.01). However, there were no statistically significant differences between LCLR and OCLR regarding hospital expenses (MD 0.92; P = 0.12), pedicle clamping (OR 1.57; P = 0.32), postoperative complications (OR 0.58; P = 0.15), bile leak (P = 0.88), ascites (P = 0.34), and incisional infection (P = 0.36).

Conclusions

LCLR has multiple advantages over OCLR, especially intraoperative blood loss and hospital stays. LCLR is a very useful technology and feasible choice in patients with caudate lobe lesions.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by National Natural Science Foundation of China (no. 81760514), and Science and Technology Plan Project of Jiangxi Provincial Health Commission (no.20175203).

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Author notes

  1. Zigang Ding, Lingpeng Liu and Bangran Xu contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, The Second Affiliated Hospital of Nanchang University, No.1, Minde Road, Nanchang, 330006, Jiangxi, China

    Zigang Ding, Lingpeng Liu, Bangran Xu, Yong Huang, Hu Xiong, Dilai Luo & Mingwen Huang

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  1. Zigang Ding
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Contributions

Study conception and design: ZG Ding, YH, LP Liu, BR Xu, HX, DL Luo, MW Huang. Data collection: ZG Ding, YH, LP Liu, BR Xu. Data analysis: ZG Ding, YH. Data interpretation: ZG Ding, YH. Writing of manuscript: ZG Ding, YH, LP Liu, BR Xu. Creation of figures: ZG Ding, YH. Critical review of manuscript: YH, MW Huang. Revision of manuscript: ZG Ding, LP Liu, BR Xu. Final approval: ZG Ding, LP Liu, BR Xu, HX, DL Luo, MW Huang.

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Correspondence to Mingwen Huang.

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Ding, Z., Liu, L., Xu, B. et al. Safety and feasibility for laparoscopic versus open caudate lobe resection: a meta-analysis. Langenbecks Arch Surg 406, 1307–1316 (2021). https://doi.org/10.1007/s00423-020-02055-y

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