1. Safety and feasibility for laparoscopic versus open caudate lobe resection: a meta-analysis
- Author
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Zigang Ding, Lingpeng Liu, Dilai Luo, Bangran Xu, Hu Xiong, Mingwen Huang, and Yong Huang
- Subjects
medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Operative Time ,Population ,030230 surgery ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,medicine ,Hepatectomy ,Humans ,Multicenter Studies as Topic ,education ,education.field_of_study ,business.industry ,Odds ratio ,Length of Stay ,Vascular surgery ,Confidence interval ,Surgery ,Cardiac surgery ,Liver ,Cardiothoracic surgery ,030220 oncology & carcinogenesis ,Feasibility Studies ,Laparoscopy ,business ,Abdominal surgery - Abstract
Laparoscopic hepatectomy has been used widely due to its advantages as a minimally invasive surgery. However, multicenter, large-scale, population-based laparoscopic caudate lobe resection (LCLR) versus open caudate lobe resection (OCLR) has rarely been reported. We assessed the feasibility and safety of LCLR compared with OCLR using meta-analysis. Relevant literature was retrieved using PubMed, Embase, Cochrane, Ovid Medline, Web of Science, CNKI, and WanFang Med databases up to July 30th, 2020. Multiple parameters of feasibility and safety were compared between the treatment groups. Quality of studies was assessed with the Newcastle-Ottawa Scale (NOS). The data were analyzed by Review Manager 5.3. Results are expressed as odds ratio (OD) or mean difference (MD) with 95% confidence interval (95% CI) for fixed- and random-effects models. Seven studies with 237 patients were included in this meta-analysis. Compared with OCLR, the LCLR group had a lower intraoperative blood loss (MD − 180.84; 95% CI − 225.61 to − 136.07; P < 0.0001), shorter postoperative hospital stays (MD − 4.38; 95% CI − 7.07 to − 1.7; P = 0.001), shorter operative time (MD − 50.24; 95% CI − 78.57 to − 21.92; P = 0.0005), and lower rates in intraoperative blood transfusion (OR 0.12; P = 0.01). However, there were no statistically significant differences between LCLR and OCLR regarding hospital expenses (MD 0.92; P = 0.12), pedicle clamping (OR 1.57; P = 0.32), postoperative complications (OR 0.58; P = 0.15), bile leak (P = 0.88), ascites (P = 0.34), and incisional infection (P = 0.36). LCLR has multiple advantages over OCLR, especially intraoperative blood loss and hospital stays. LCLR is a very useful technology and feasible choice in patients with caudate lobe lesions.
- Published
- 2021