A systematic review and network meta-analysis of outcomes after open, mini-laparotomy, hybrid, totally laparoscopic, and robotic living donor right hepatectomy

被引：18

作者：

Yeow, Marcus ^{[1
]}

Soh, Shauna ^{[1
]}

Starkey, Graham ^{[2
]}

Perini, Marcos, V ^{[2
,3
]}

Koh, Ye-Xin ^{[4
]}

Tan, Ek-Khoon ^{[4
]}

Chan, Chung-Yip ^{[4
]}

Raj, Prema ^{[4
]}

Goh, Brian K. P. ^{[4
,5
]}

Kabir, Tousif ^{[2
,6
]}

机构：

[1] Natl Univ Singapore, Yong Loo Lin Sch Med, Singapore, Singapore

[2] Austin Hlth, Victorian Liver Transplant Unit, Melbourne, Vic, Australia

[3] Univ Melbourne, Dept Surg, Austin Hlth, Melbourne, Vic, Australia

[4] Singapore Gen Hosp, Dept Hepatopancreatobiliary & Transplant Surg, Singapore, Singapore

[5] Natl Univ Singapore, Duke NUS Grad Med Sch, Singapore, Singapore

[6] Sengkang Gen Hosp, Dept Gen Surg, Singapore, Singapore

来源：

SURGERY | 2022年 / 172卷 / 02期

关键词：

LIVER-TRANSPLANTATION; PURE; SURGERY; COMPLICATIONS; STATEMENT; RESECTION; INCISION; IMPACT; COHORT;

D O I：

10.1016/j.surg.2022.03.042

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: A systematic review and network meta-analysis was performed to compare outcomes after living donor right hepatectomy via the following techniques: conventional open (Open), mini-laparotomy (Minilap), hybrid (Hybrid), totally laparoscopic (Lap), and robotic living donor right hepatectomy (Robotic). Methods: PubMed, EMBASE, Cochrane, and Scopus were searched from inception to August 2021 for comparative studies of patients who underwent living donor right hepatectomy. Results: Nineteen studies comprising 2,261 patients were included. Operation time was longer in Lap versus Minilap and Open (mean difference 65.09 min, 95% confidence interval 3.40-126.78 and mean difference 34.81 minutes, 95% confidence interval 1.84-67.78), and in Robotic versus Hybrid, Lap, Minilap, and Open (mean difference 144.72 minutes, 95% confidence interval 89.84-199.59, mean difference 113.24 minutes, 95% confidence interval 53.28-173.20, mean difference 178.33 minutes, 95% confidence interval 105.58-251.08 and mean difference 148.05 minutes, 95% confidence interval 97.35-198.74, respectively). Minilap and Open were associated with higher blood loss compared to Lap (mean difference 258.67 mL, 95% confidence interval 107.00-410.33 and mean difference 314.11 mL, 95% confidence interval 143.84-484.37) and Robotic (mean difference 205.60 mL, 95% confidence interval 45.92-365.28 and mean difference 261.04 mL, 95% confidence interval 84.26-437.82). Open was associated with more overall complications compared to Minilap (odds ratio 2.60, 95% confidence interval 1.11-6.08). Recipient biliary complication rate was higher in Minilap and Open versus Hybrid (odds ratio 3.91, 95% confidence interval 1.13-13.55 and odds ratio 11.42, 95% confidence interval 2.27-57.49), and lower in Open versus Minilap (OR 0.07, 95% confidence interval 0.01-0.34). Conclusion: Minimally invasive donor right hepatectomy via the various techniques is safe and feasible when performed in high-volume centers, with no major differences in donor complication rates and comparable recipient outcomes once surgeons have mounted the learning curve. (C) 2022 Elsevier Inc. All rights reserved.

引用

页码：741 / 750

页数：10

共 53 条

[11] Comparing purely laparoscopic versus open living donor right hepatectomy: propensity score-matched analysis
Cho, H-D
Kim, K-H
Yoon, Y-, I
Kang, W-H
Jung, D-H
Park, G-C
Hwang, S.
Ahn, C-S
Moon, D-B
Ha, T-Y
Song, G-W
Park, J-, I
Lee, S-G
[J]. BRITISH JOURNAL OF SURGERY, 2021, 108 (07) : E233 - E234
[12] Single-Port Laparoscopy-Assisted Donor Right Hepatectomy in Living Donor Liver Transplantation: Sensible Approach or Unnecessary Hindrance?
Choi, H. J.
You, Y. K.
Na, G. H.
Hong, T. H.
Shetty, G. S.
Kim, D. G.
[J]. TRANSPLANTATION PROCEEDINGS, 2012, 44 (02) : 347 - 352
[13] Comparative Short-term Benefits of Laparoscopic Liver Resection: 9000 Cases and Climbing
Ciria, Ruben
Cherqui, Daniel
Geller, David A.
Briceno, Javier
Wakabayashi, Go
[J]. ANNALS OF SURGERY, 2016, 263 (04) : 761 - 777
[14] Laparoscopy-assisted versus open and pure laparoscopic approach for liver resection and living donor hepatectomy: a systematic review and meta-analysis
Coelho, Fabricio F.
Bernardo, Wanderley M.
Kruger, Jaime A. P.
Jeismann, Vagner B.
Fonseca, Gilton M.
Macacari, Rodrigo L.
Cesconetto, Danielle M.
D'Albuquerque, Luiz A. C.
Cecconello, Ivan
Herman, Paulo
[J]. HPB, 2018, 20 (08) : 687 - 694
[15] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey
Dindo, D
Demartines, N
Clavien, PA
[J]. ANNALS OF SURGERY, 2004, 240 (02) : 205 - 213
[16] Characteristics associated with liver graft failure: The concept of a donor risk index
Feng, S
Goodrich, NP
Bragg-Gresham, JL
Dykstra, DM
Punch, JD
DebRoy, MA
Greenstein, SM
Merion, RM
[J]. AMERICAN JOURNAL OF TRANSPLANTATION, 2006, 6 (04) : 783 - 790
[17] Imputing missing standard deviations in meta-analyses can provide accurate results
Furukawa, TA
Barbui, C
Cipriani, A
Brambilla, P
Watanabe, N
[J]. JOURNAL OF CLINICAL EPIDEMIOLOGY, 2006, 59 (01) : 7 - 10
[18] Comparison of laparoscopic and open living donor hepatectomy A meta-analysis
Gao, Yuye
Wu, Wu
Liu, Chunyu
Liu, Tao
Xiao, Heng
[J]. MEDICINE, 2021, 100 (32) : E26708
[19] Enhanced secondary analysis of survival data: reconstructing the data from published Kaplan-Meier survival curves
Guyot, Patricia
Ades, A. E.
Ouwens, Mario J. N. M.
Welton, Nicky J.
[J]. BMC MEDICAL RESEARCH METHODOLOGY, 2012, 12
[20] Role of Hand-Assisted Laparoscopic Surgery in Living-Donor Right Liver Harvest
Ha, T. Y.
Hwang, S.
Ahn, C. S.
Kim, K. H.
Moon, D. B.
Song, G. W.
Jung, D. H.
Park, G. C.
Namgoong, J. M.
Park, C. S.
Park, Y. H.
Park, H. W.
Kang, S. H.
Jung, B. H.
Lee, S. -G.
[J]. TRANSPLANTATION PROCEEDINGS, 2013, 45 (08) : 2997 - 2999

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