Pure laparoscopic versus open left lateral hepatectomy in pediatric living donor liver transplantation: a review and meta-analysis

被引:5
作者
Sha, Meng [1 ]
Zong, Zhi-peng [1 ]
Shen, Chuan [1 ]
Zhu, Jian-jun [1 ]
Feng, Ming-xuan [1 ]
Luo, Yi [1 ]
Tong, Ying [1 ]
Xia, Qiang [1 ]
机构
[1] Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Dept Liver Surg, 1630 Dongfang Rd, Shanghai 200127, Peoples R China
基金
中国国家自然科学基金;
关键词
Pure laparoscopic hepatectomy; Open left lateral hepatectomy; Pediatric; Living donor liver transplantation; HEPATIC LOBECTOMY; SAFETY;
D O I
10.1007/s12072-022-10471-z
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Purpose The meta-analysis was conducted to evaluate the safety and feasibility of pure laparoscopic left lateral hepatectomy in comparison with open approach for pediatric living donor liver transplantation (LDLT).Methods A systemic literature survey was performed by searching the PubMed, EMBASE and Cochrane Library databases for articles that compared pure laparoscopic left lateral living donor hepatectomy (LLDH) and open left lateral living donor hepatectomy (OLDH) by November 2021. Meta-analysis was performed to assess donors' and recipients' perioperative outcomes using RevMan 5.3 software.Results A total of five studies involving 432 patients were included in the analysis. The results demonstrated that LLDH group had significantly less blood loss (WMD = -99.28 ml, 95%CI -152.68 to -45.88, p = 0.0003) and shorter length of hospital stay (WMD = -2.71d, 95%CI -3.78 to -1.64, p < 0.00001) compared with OLDH group. A reduced donor overall postoperative complication rate was observed in the LLDH group (OR = 0.29, 95%CI 0.13-0.64, p = 0.002). In the subgroup analysis, donor bile leakage, wound infection and pulmonary complications were similar between two groups (bile leakage: OR = 1.31, 95%CI 0.43-4.02, p = 0.63; wound infection: OR = 0.38, 95%CI 0.10-1.41, p = 0.15; pulmonary complications: OR = 0.24, 95%CI 0.04-1.41, p = 0.11). For recipients, there were no significant difference in perioperative outcomes between the LLDH and OLDH group, including mortality, overall complications, hepatic artery thrombosis, portal vein and biliary complications.Conclusion LLDH is a safe and effective alternative to OLDH for pediatric LDLT, reducing invasiveness and benefiting postoperative recovery. Future large-scale multi-center studies are expected to confirm the advantages of LLDH in pediatric LDLT.
引用
收藏
页码:1587 / 1595
页数:9
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