Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study.
hepatectomy
laparoscopy
liver resection
posterosuperior segments
risk score
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
revised:
05
04
2022
received:
15
02
2022
accepted:
22
06
2022
pubmed:
28
6
2022
medline:
17
2
2023
entrez:
27
6
2022
Statut:
ppublish
Résumé
Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Sections du résumé
BACKGROUND
BACKGROUND
Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8.
METHODS
METHODS
A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8.
RESULTS
RESULTS
A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay.
CONCLUSION
CONCLUSIONS
Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
177-191Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Investigateurs
Chung-Yip Chan
(CY)
Nicholas Syn
(N)
Mizelle D'Silva
(M)
Boram Lee
(B)
Chetana Lim
(C)
Phan Phuoc Nghia
(PP)
Mikel Gastaca
(M)
Henri Schotte
(H)
Celine De Meyere
(C)
Felix Krenzien
(F)
Moritz Schmelzle
(M)
Kit-Fai Lee
(KF)
Lip Seng Lee
(LS)
Jae Young Jang
(JY)
Masayuki Kojima
(M)
Yutaro Kato
(Y)
Jacob Ghotbi
(J)
Jaime Arthur Pirola Kruger
(JAP)
Fabricio Ferreira Coelho
(FF)
Victor Lopez-Lopez
(V)
Bernardo Dalla Valle
(BD)
Margarida Casellas I Robert
(MCI)
Kohei Mishima
(K)
Roberto Montalti
(R)
Mariano Giglio
(M)
Hao-Ping Wang
(HP)
Franco Pascual
(F)
Mansour Saleh
(M)
Prashant Kadam
(P)
Chung-Ngai Tang
(CN)
Francesco Ardito
(F)
Simone Vani
(S)
Ugo Giustizieri
(U)
Davide Citterio
(D)
Federico Mocchegiani
(F)
Giuseppe Maria Ettorre
(GM)
Marco Colasanti
(M)
Yoelimar Guzmán
(Y)
Epameinondas Dogeas
(E)
Paolo Magistri
(P)
Alessandro Mazzotta
(A)
Informations de copyright
© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.
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