Short-term and middle-term evaluation of laparoscopic hepatectomies compared with open hepatectomies

来源 :World Journal of Gastrointestinal Surgery | 被引量 : 0次 | 上传用户:sjay357
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AIM To compare short-term results between laparoscopic hepatectomy and open hepatectomy using a propensity score matching. METHODS A patient in the laparoscopic liver resection(LLR) groupwas randomly matched with another patient in the open liver resection(OLR) group using a 1:1 allocated ratio with the nearest estimated propensity score. Patients of the LLR group without matches were excluded. Matching criteria included age, gender, body mass index, American Society of Anesthesiologists score, potential co-morbidities, hepatopathies, size and number of nodules, preoperative chemotherapy, minor or major liver re-sections. Intraoperative and postoperative data were compared in both groups.RESULTS From January 2012 to January 2015, a total of 241 hepa-tectomies were consecutively performed, of which 169 in the OLR group(70.1%) and 72 in the LLR group(29.9%). The conversion rate was 9.7%(n = 7). The mortality rate was 4.2% in the OLR group and 0% in the LLR group. Prior to and after propensity score matching, there was a statistically significant difference favorable to the LLR group regarding shorter operative times(185 min vs 247.5 min; P = 0.002), less blood loss(100 m L vs 300 m L; P = 0.002), a shorter hospital stay(7 d vs 9 d; P = 0.004), and a significantly lower rate of medical complications(4.3% vs 26.4%; P < 0.001). CONCLUSION Laparoscopic liver resections seem to yield better short-term and mid-term results as compared to open hepatectomies and could well be considered a privileged approach and become the gold standard in carefully selected patients. AIM To compare short-term results between laparoscopic hepatectomy and open hepatectomy using a propensity score matching. METHODS A patient in the laparoscopic liver resection (LLR) group was randomly matched with another patient in the open liver resection (OLR) group using a 1: 1 Patients with the LLR group without matches were excluded. Matching criteria included age, gender, body mass index, American Society of Anesthesiologists score, potential co-morbidities, hepatopathies, size and number of nodules, preoperative chemotherapy, minor or major liver re-sections. Intraoperative and postoperative data were compared in both groups. RESULTS From January 2012 to January 2015, a total of 241 hepa-tectomies were consecutively performed, of which 169 in the OLR group (70.1%) and 72 in the LLR group (29.9%). The conversion rate was 9.7% (n = 7). The mortality rate was 4.2% in the OLR group and 0% in the LLR group. Prior to and after prope nsity score matching, there was a significant difference favorable to the LLR group for shorter operative times (185 min vs 247.5 min; P = 0.002), less blood loss (100 m L vs 300 m L; P = 0.002) CONCLUSIONS Laparoscopic liver resections seem to yield better short-term and mid-term results (7 d vs 9 d; P = 0.004) and a significantly lower rate of medical complications (4.3% vs 26.4% as compared to open hepatectomies and could well be considered a privileged approach and become the gold standard in carefully selected patients.
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