Operative and Hepatic Function Outcomes of Laparoscopic vs. Open Liver Resection: A Systematic Review and Meta-Analysis

被引:1
作者
Mithany, Reda H. [1 ]
Gerges, Farid [2 ]
Shahid, M. Hasaan [3 ]
Abdallah, Shenouda [4 ]
Manasseh, Mina [5 ]
Abdelmaseeh, Mark [6 ]
Abdalla, Mazin [7 ]
Elmahi, Eiad [8 ]
机构
[1] Kingston Hosp Natl Hlth Serv NHS Fdn Trust, Laparoscop Colorectal Surg, Kingston, England
[2] Kingston Hosp Natl Hlth Serv NHS Fdn Trust, Gen & Emergency Surg, Kingston, England
[3] Postgrad Med Inst, Surg, Lahore, Pakistan
[4] Jaber Al Ahmad Hosp, Surg, Kuwait, Kuwait
[5] Torbay & South Devon Natl Hlth Serv NHS Fdn Trust, Gen Surg, Torquay, England
[6] Assiut Univ, Fac Med, Gen Surg, Assiut, Egypt
[7] Kingston Hosp Natl Hlth Serv NHS Fdn Trust, Gen Surg, London, England
[8] Lincoln Cty Hosp, Gen Surg, Lincoln, England
关键词
systematic review; hepatectomy complications; post-hepatectomy bleeding; open liver resection; laparoscopic liver resection; OPEN HEPATECTOMY; SURGERY;
D O I
10.7759/cureus.47274
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Liver resection is a pivotal treatment for various liver diseases, and the choice between laparoscopic (LR) and open (OR) methods is debatable. This study aims to compare their respective complications and hepatic outcomes comprehensively, providing critical insights to guide clinical decisions and optimize patient results.We conducted a comprehensive review across PubMed, SCOPUS, WOS, and the Cochrane Library until September 2023. Randomized controlled trials (RCTs) comparing laparoscopic (LR) and open (OR) liver resections were included. Data screening, extraction, and quality assessments utilized the Risk of Bias (ROB 2). We conducted our analysis using Review Manager (RevMan 5.4) software, and the data were presented as risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI).Our comprehensive research yielded 3,192 relevant records, and 9 RCTs were finally included. LR exhibited reduced operative bleeding (MD =-82.87 ml, 95% CI:-132.45 to-33.30, P=0.001) and shorter hospital stays (MD =-2.32 days, 95% CI:-3.65 to-0.98, P=0.0007). The risk of complications was significantly lower in the LR group (RR = 0.57, 95% CI: 0.43-0.76, P<0.0001), especially in Clavian-Dindo classification degree 1 and 2 complications (RR = 0.47, 95% CI: 0.28-0.79, P=0.005). LR patients also had lower postoperative AST levels at one day (MD =-123.16 U/L, 95% CI:-206.08 to-40.24, P=0.004) and three days (MD =-35.95 U/L, 95% CI: 65.83 to-6.06, P=0.02).These findings underscore LR's superiority, emphasizing its potential to significantly enhance patient outcomes, reduce complications, and improve recovery in liver resection procedures.
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页数:12
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