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Laparoscopic caudate lobectomy: a multicenter, propensity score-matched report of safety, feasibility, and early outcomes

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Abstract

Background

Caudate lobectomy via laparoscopic surgery has rarely been described. This multicenter, propensity score-matched study was performed to assess the safety and efficacy of laparoscopic caudate lobectomy (LCL).

Methods

A multicenter retrospective study was performed including all patients who underwent LCL and open caudate lobectomy (OCL) in four institutions from January 2013 to December 2018. In total, 131 patients were included in this study and divided into LCL (n = 19) and OCL (n = 112) groups. LCLs were matched to OCLs (1:2) using a propensity score matching (PSM) based on nine preoperative variables, including patient demographics and tumor characteristics. The pathological results, perioperative and postoperative parameters, and short-term outcomes were compared between the two groups.

Results

After PSM, there were 18 and 36 patients in the LCL and OCL groups, respectively. Baseline characteristics were comparable after matching. LCL was associated with less blood (100 vs. 300 ml, respectively; P < 0.001) and a shorter postoperative stay (6.0 vs 8.0 days, respectively; P = 0.003). Most patients’ resection margins were > 10 mm in the LCL group (P = 0.021), and all patients with malignancy in both groups achieved R0 resection. In terms of early postoperative outcomes, the overall morbidity rate was identical in each group (11.1% vs. 11.1%, respectively; P = 1.000). No mortality occurred in either group.

Conclusions

Laparoscopy is a feasible choice for resection of tumors located in the caudate lobe with acceptable perioperative results.

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Acknowledgements

The authors would like to thank Angela Morben, Ph.D, from Liwen Bianji, Edanz Editing China (www.liwenbianji.cn/ac), for editing the English text of a draft of this manuscript.

Funding

This research was supported by National Natural Science Foundation of China (Grant No. 81972698), CAMS Initiative for Innovative Medicine (Grant No. CAMS-2017-I2M-4-002) and Peking Union Medical College Graduate Student Innovation Fund (Grant No. 2019-1002-45).

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Author notes

  1. Gang Xu and Junxiang Tong contributed equally to this work

Authors and Affiliations

  1. Department of Liver Surgery, Peking Union Medical College (PUMC) Hospital, PUMC and Chinese Academy of Medical Sciences, Dongcheng, Beijing, 100730, China

    Gang Xu, Xiang’an Wu, Bao Jin, Haifeng Xu, Xin Lu, Xinting Sang, Yilei Mao & Shunda Du

  2. Department of Hepatobiliary Surgery, Chinese PLA General Hospital, Haidian, Beijing, 100142, China

    Junxiang Tong & Hongguang Wang

  3. Department of Hepatobiliary Surgery, Beijing Tongren Hospital, Capital Medical University, Dongcheng, Beijing, 100730, China

    Jiajun Ji

  4. Department of Hepatobiliary Surgery, Fifth Medical Center of Chinese PLA General Hospital, Fengtai, Beijing, 100039, China

    Zhixian Hong

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  1. Gang Xu
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Correspondence to Shunda Du or Zhixian Hong.

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Drs. Gang Xu, Junxiang Tong, Jiajun Ji, Hongguang Wang, Xiang’an Wu, Bao Jin, Haifeng Xu, Xin Lu, Xinting Sang, Yilei Mao, Shunda Du and Zhixiang Hong have no conflict of interest or financial ties to disclose.

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Xu, G., Tong, J., Ji, J. et al. Laparoscopic caudate lobectomy: a multicenter, propensity score-matched report of safety, feasibility, and early outcomes. Surg Endosc 35, 1138–1147 (2021). https://doi.org/10.1007/s00464-020-07478-8

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