Dataset Information

The role of laparoscopic surgery in the surgical management of recurrent liver malignancies: A systematic review and meta-analysis.

ABSTRACT:

Objective

To evaluate the efficiency of laparoscopic surgery in treating recurrent liver tumors vs. conventional open surgery.

Methods

Database searching was conducted in PubMed, the Cochrane Library and EMBASE. Rev Man 5.3 software and Stata 13.0 software were applied in statistical analyses.

Results

A total of fourteen studies were finally included with 1,284 patients receiving LRH and 2,254 with ORH. LRH was associated with less intraoperative hemorrhage, a higher R0 resection rate, a lower incidence of Pringle Maneuver, a lower incidence of postoperative morbidities, a better overall survival and an enhanced postoperative recovery vs. ORH. Patients receiving LRH shared similar operative time, tumor number and disease-free survival as those with ORH. However, tumor size was relatively larger in patients receiving ORH and major hepatectomy, anatomic hepatectomy were rarely performed in patients with LRH. Additional analyses between LRH and laparoscopic primary hepatectomy revealed less intraoperative blood loss in patients with LRH.

Conclusion

LRH is safe and feasible with more favorable peri-operative outcomes and faster postoperative recovery. However, it is only applicable for some highly-selected cases not requiring complex surgical procedures. Future larger well-designed studies are expected for further validation.

SUBMITTER: Lv TR

PROVIDER: S-EPMC9852625 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

The role of laparoscopic surgery in the surgical management of recurrent liver malignancies: A systematic review and meta-analysis.

Lv Tian-Run TR Hu Hai-Jie HJ Ma Wen-Jie WJ Hu Ya-Fei YF Dai Yu-Shi YS Li Fu-Yu FY

Frontiers in surgery 20230106

<h4>Objective</h4>To evaluate the efficiency of laparoscopic surgery in treating recurrent liver tumors vs. conventional open surgery.<h4>Methods</h4>Database searching was conducted in PubMed, the Cochrane Library and EMBASE. Rev Man 5.3 software and Stata 13.0 software were applied in statistical analyses.<h4>Results</h4>A total of fourteen studies were finally included with 1,284 patients receiving LRH and 2,254 with ORH. LRH was associated with less intraoperative hemorrhage, a higher R0 res ...[more]

PMID: 36684258

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Project description:BACKGROUND: Evidence of benefits of laparoscopic and laparoscopic-assisted colectomies (LAC) over open procedures in gastrointestinal surgery has continued to accumulate. With its wide implementation, technical difficulties and limitations of LAC have become clear. Hand-assisted laparoscopic surgery (HALS) was introduced in an attempt to facilitate the transition from open techniques to minimally invasive procedures. Continuing debate exists about which approach is to be preferred, HALS or LAC. Several studies have compared these two techniques in colorectal surgery, but no single study provided evidence which procedure is superior. Therefore, a systematic review was carried out comparing HALS with LAC colorectal resection. METHODS: Eligible studies were identified from electronic databases (Medline, Embase Cochrane) and cross-reference search. The database search, quality assessment, and data extraction were independently performed by two reviewers. Minimal outcome criteria for inclusion were operating time, conversion rate, hospital stay, and morbidity. RESULTS: Out of 468 studies a total of 13 studies were selected for comprehensive review. Two randomized controlled trials (RCT) and 11 non-RCTs, comprising 1017 patients, met the inclusion criteria. Because of possible clinical heterogeneity two groups of procedures were created: segmental colectomies and total (procto)colectomies. In the segmental colectomy group significant differences in favor of the HALS group were seen in operating time (WMD 19 min) and conversion rate (OR of 0.3 conversions). In the total (procto)colectomy group a significant difference in favor of the HALS group was seen in operating time (WMD 61 min). CONCLUSIONS: This systematic review indicates that HALS provides a more efficient segmental colectomy regarding operating time and conversion rate, particularly accounting for diverticulitis. A significant operating time advantage exists for HALS total (procto)colectomy. HALS must therefore be considered a valuable addition to the laparoscopic armamentarium to avoid conversion and speed up complicated colectomies.

Dataset Information

The role of laparoscopic surgery in the surgical management of recurrent liver malignancies: A systematic review and meta-analysis.

Objective

Methods

Results

Conclusion

Publications

The role of laparoscopic surgery in the surgical management of recurrent liver malignancies: A systematic review and meta-analysis.

Similar Datasets

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