The differential benefit of laparoscopic over open minor liver resection for lesions situated in the anterolateral or posterosuperior segments  

作　　者：Jasper P.Sijberden Guido Fiorentini Jacopo Lanari Davit Aghayan Daniel Osei-Bordom Nadia Russolillo Arjun Takhar Andrea Benedetti Cacciaguerra Santi Lopez-Ben Mathieu D’Hondt Felice Giuliante David Fuks Fernando Rotellar Andrea Ruzzenente Adnan Alseidi Mikhail Efanov Burak Görgec Giuseppe Zimmitti Enrico Gringeri Federica Cipriani Åsmund Avdem Fretland Ravi Marudanayagam Marco Vivarelli John N.Primrose Alessandro Ferrero Robert P.Sutcliffe Bjørn Edwin Umberto Cillo Marc G.Besselink Mohammad Abu Hilal Luca A.Aldrighetti 

机构地区：[1]Department of Surgery,Fondazione Poliambulanza Istituto Ospedaliero,Brescia,Italy [2]Amsterdam UMC location University of Amsterdam,Department of Surgery,Amsterdam,the Netherlands [3]Cancer Center Amsterdam,Amsterdam,the Netherlands [4]Hepatobiliary Surgery Division,IRCCS San Raffaele Hospital,Milan,Italy [5]Department of Surgical,Oncological and Gastroenterological Sciences,General Surgery 2,Hepatobiliary Surgery and Liver Transplantation,Padua University Hospital,Padua,Italy [6]The Intervention Centre and Department of HPB Surgery,Oslo University Hospital and Institute of Clinical Medicine,University of Oslo,Oslo,Norway [7]Department of Surgery,Ringerike Hospital,Vestre Viken Hospital Trust,Drammen,Norway [8]Liver Unit,Queen Elizabeth Hospital,Birmingham,UK [9]Department of General and Oncological Surgery,Umberto I Mauriziano Hospital,Largo Turati,Turin,Italy [10]Department of Surgery,University Hospital Southampton NHS Foundation Trust,Southampton,UK [11]Hepatobiliary and Abdominal Transplantation Surgery,Department of Experimental and Clinical Medicine,Riuniti Hospital,Polytechnic University of Marche,Ancona,Italy [12]Servei de Cirurgia General i Digestiva,Hospital Doctor Josep Trueta de Girona,Girona,Catalonia,Spain [13]Department of Digestive and Hepatobiliary/Pancreatic Surgery,Groeninge Hospital,Kortrijk,Belgium [14]Chirurgia Epatobiliare,UniversitàCattolica del Sacro Cuore-IRCCS,Rome,Italy [15]Department of Digestive,Oncologic and Metabolic Surgery,Institut Mutualiste Montsouris,UniversitéParis Descartes,Paris,France [16]HPB and Liver Transplantation Unit,Department of Surgery,University Clinic,Universidad de Navarra,Navarra,Spain [17]Institute of Health Research of Navarra(IdisNA),Pamplona,Spain [18]Department of Surgery,University of Verona,Verona,Italy [19]Department of Surgery,Virginia Mason Medical Center,Seattle,WA,USA [20]Department of Surgery,University of California San Francisco,San Francisco,CA,USA [21]Department of Hepato-Pancreato-Biliary Surgery,Moscow Clinical Research Centre,Moscow,R

出　　处：《Hepatobiliary Surgery and Nutrition》2024年第4期604-615,I0015-I0021,共19页肝胆外科与营养（英文）

摘　　要：Background:It is well known that laparoscopic liver surgery can offer advantages over open liver surgery in selected patients.However,what type of procedures can benefit most from a laparoscopic approach has been investigated poorly thus far.The aim of this study is thus to define the extent of advantages of laparoscopic over open liver surgery for lesions in the anterolateral(AL)and posterosuperior(PS)segments.Methods:In this international multicentre retrospective cohort study,laparoscopic and open minor liver resections for lesions in the AL and PS segments were compared after propensity score matching.The differential benefit of laparoscopy over open liver surgery,calculated using bootstrap sampling,was compared between AL and PS resections and expressed as a Delta of the differences.Results:After matching,3,040 AL and 2,336 PS resections were compared,encompassing open and laparoscopic procedures in a 1:1 ratio.AL and PS laparoscopic liver resections were more advantageous in comparison to open in terms of blood loss,transfusion rate,complications,and length of stay.However,AL resections benefitted more from laparoscopy than PS in terms of overall and severe complications(D-difference were 4.8%,P=0.046 and 3%,P=0.046)and blood loss(D-difference was 195 mL,P<0.001).Similar results were observed in the subset for high-volume centres,while in recent years no significant differences were found in the differential benefit between AL and PS segments.Conclusions:The advantage of laparoscopic over open liver surgery is greater in the AL segments than in the PS segments.

关 键 词：Liver neoplasms HEPATECTOMY laparoscopic liver resection open liver resection 

分 类 号：R657.3[医药卫生—外科学]