Short-term Outcomes of Laparoscopic Versus Open Liver Resection in the Elderly: A Propensity Score-matched Analysis

被引:0
作者
Igarashi, Yosuke [1 ]
Haruki, Koichiro [1 ,2 ]
Furukawa, Kenei [1 ]
Taniai, Tomohiko [1 ]
Yanagaki, Mitsuru [1 ]
Okui, Norimitsu [1 ]
Shirai, Yoshihiro [1 ]
Tsunematsu, Masashi [1 ]
Sakamoto, Taro [1 ]
Ikegami, Toru [1 ]
机构
[1] Jikei Univ, Sch Med, Div Hepatobiliary & Pancreat Surg, Tokyo, Japan
[2] Jikei Univ, Sch Med, Dept Surg, Div Hepatobiliary & Pancreat Surg, 3-25-8 Nishi Shinbashi,Minato Ku, Tokyo 1058461, Japan
关键词
Laparoscopic surgery; hepatic resection; elderly; HEPATOCELLULAR-CARCINOMA; HEPATECTOMY;
D O I
10.21873/anticanres.17081
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background/Aim: With the aging of the population, there is a rising proportion of elderly patients undergoing liver resection. However, the safety and efficacy of laparoscopic liver resection (LLR) in the elderly have not yet been established. In this study, we compared the short-term results of LLR and open liver resection (OLR) in elderly patients using propensity score matched (PSM) analysis. Patients and Methods: The study comprised 237 elderly patients aged 65 years and older who had undergone liver resection between 2015 to 2021, excluding biliary and vascular reconstruction and simultaneous surgeries other than liver resection. We conducted PSM analysis for baseline characteristics (age, sex, BMI, ASA-PS, disease, procedure, tumor size, and number of tumors) to eliminate potential selection bias. We then compared short-term postoperative outcomes between LLR and OLR groups in patients selected by PSM analysis. Results: Applying PSM analysis, 90 cases each were selected for the LLR and OLR groups. The LLR group had a significantly lower complication rate (Clavien-Dindo: CD >= II) (19% vs. 33%, p=0.03), especially bile leakage (CD >= II) (0% vs. 6.7%, p=0.03) compared with those in the OLR group. In addition, a shorter operation time (244 min vs. 351 min, p<0.01), less blood loss (150 ml vs. 335 ml, p<0.01), and shorter hospital stay (8 days vs. 12 days, p<0.01) were observed in the LLR group. No operative or in-hospital deaths were observed in both groups. Conclusion: LLR can be safely performed in elderly patients and offers better short-term outcomes.
引用
收藏
页码:2731 / 2736
页数:6
相关论文
共 23 条
[1]   Laparoscopic Liver Resection Procedure Attenuates Organ-space Surgical Site Infection Compared With Open Procedure: A Propensity Score-matched Analysis [J].
Araki, Kenichiro ;
Harimoto, Norifumi ;
Watanabe, Akira ;
Tsukagoshi, Mariko ;
Ishii, Norihiro ;
Hagiwara, Kei ;
Muranushi, Ryo ;
Hoshino, Kouki ;
Seki, Takaomi ;
Shirabe, Ken .
ANTICANCER RESEARCH, 2023, 43 (05) :2273-2280
[2]  
Baquero GA, 2015, J GERIATR CARDIOL, V12, P465, DOI 10.11909/j.issn.1671-5411.2015.05.018
[3]   Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].
Dindo, D ;
Demartines, N ;
Clavien, PA .
ANNALS OF SURGERY, 2004, 240 (02) :205-213
[4]   Evaluation of the risk factors and prognostic factors of hepatectomy for hepatocellular carcinoma in patients aged 80 years or more [J].
Hamaoka, Michinori ;
Kobayashi, Tsuyoshi ;
Ishiyama, Kohei ;
Ohira, Masahiro ;
Tahara, Hiroyuki ;
Kuroda, Shintaro ;
Iwako, Hiroshi ;
Okimoto, Sho ;
Honmyo, Naruhiko ;
Ohdan, Hideki .
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 2017, 24 (01) :58-64
[5]   Effectiveness of Anatomical Resection for Small Hepatocellular Carcinoma: a Propensity Score-Matched Analysis of a Multi-institutional Database [J].
Haruki, Koichiro ;
Furukawa, Kenei ;
Fujiwara, Yuki ;
Taniai, Tomohiko ;
Hamura, Ryoga ;
Shirai, Yoshihiro ;
Yasuda, Jungo ;
Shiozaki, Hironori ;
Onda, Shinji ;
Gocho, Takeshi ;
Shiba, Hiroaki ;
Usuba, Teruyuki ;
Nakabayashi, Yukio ;
Fujioka, Shuichi ;
Okamoto, Tomoyoshi ;
Ikegami, Toru .
JOURNAL OF GASTROINTESTINAL SURGERY, 2021, 25 (11) :2835-2841
[6]   Safety and efficacy for laparoscopic versus open hepatectomy: A meta-analysis [J].
Jin, Bao ;
Chen, Mei-ting ;
Fei, Yu-tong ;
Du, Shun-da ;
Mao, Yi-lei .
SURGICAL ONCOLOGY-OXFORD, 2018, 27 (02) :A26-A34
[7]   Annual report on National Clinical Database 2020 for gastroenterological surgery in Japan [J].
Kajiwara, Yoshiki ;
Takahashi, Arata ;
Ueno, Hideki ;
Kakeji, Yoshihiro ;
Hasegawa, Hiroshi ;
Eguchi, Susumu ;
Goi, Takanori ;
Saiura, Akio ;
Sasaki, Akira ;
Takiguchi, Shuji ;
Takeuchi, Hiroya ;
Tanaka, Chie ;
Hashimoto, Masaji ;
Hiki, Naoki ;
Horiguchi, Akihiko ;
Matsuda, Satoru ;
Mizushima, Tsunekazu ;
Marubashi, Shigeru ;
Gotoh, Mitsukazu ;
Konno, Hiroyuki ;
Yamamoto, Hiroyuki ;
Miyata, Hiroaki ;
Seto, Yasuyuki ;
Kitagawa, Yuko .
ANNALS OF GASTROENTEROLOGICAL SURGERY, 2023, 7 (03) :367-406
[8]   Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data [J].
Kasai, Meidai ;
Cipriani, Federica ;
Gayet, Brice ;
Aldrighetti, Luca ;
Ratti, Francesca ;
Sarmiento, Juan M. ;
Scatton, Olivier ;
Kim, Ki-Hun ;
Dagher, Ibrahim ;
Topal, Bald ;
Primrose, John ;
Nomi, Takeo ;
Fuks, David ;
Abu Hilal, Mohammad .
SURGERY, 2018, 163 (05) :985-995
[9]   Bile leakage after hepatobiliary and pancreatic surgery: A definition and grading of severity by the International Study Group of Liver Surgery [J].
Koch, Moritz ;
Garden, O. James ;
Padbury, Robert ;
Rahbari, Nuh N. ;
Adam, Rene ;
Capussotti, Lorenzo ;
Fan, Sheung Tat ;
Yokoyama, Yukihiro ;
Crawford, Michael ;
Makuuchi, Masatoshi ;
Christophi, Christopher ;
Banting, Simon ;
Brooke-Smith, Mark ;
Usatoff, Val ;
Nagino, Masato ;
Maddern, Guy ;
Hugh, Thomas J. ;
Vauthey, Jean-Nicolas ;
Greig, Paul ;
Rees, Myrddin ;
Nimura, Yuji ;
Figueras, Joan ;
DeMatteo, Ronald P. ;
Buechler, Markus W. ;
Weitz, Juergen .
SURGERY, 2011, 149 (05) :680-688
[10]   Laparoscopic Versus Open Liver Resection for Colorectal Metastases in Elderly and Octogenarian Patients A Multicenter Propensity Score Based Analysis of Short- and Long-term Outcomes [J].
Martinez-Cecilia, David ;
Cipriani, Federica ;
Vishal, Shelat ;
Ratti, Francesca ;
Tranchart, Hadrien ;
Barkhatov, Leonid ;
Tomassini, Federico ;
Montalti, Roberto ;
Halls, Mark ;
Troisi, Roberto I. ;
Dagher, Ibrahim ;
Aldrighetti, Luca ;
Edwin, Bjorn ;
Abu Hilal, Mohammad .
ANNALS OF SURGERY, 2017, 265 (06) :1192-1200