TY - JOUR
T1 - Laparoscopic versus open liver resection
T2 - A matched-pair case control study
AU - Ito, Kaori
AU - Ito, Hiromichi
AU - Are, Chandrakanth
AU - Allen, Peter J.
AU - Fong, Yuman
AU - DeMatteo, Ronald P.
AU - Jarnagin, William R.
AU - D'Angelica, Michael I.
PY - 2009/12
Y1 - 2009/12
N2 - Background: Laparoscopic liver resection (LLR) has become an increasingly popular operation; however, its theoretical benefits remain unproven. The aim of this study was to conduct a comparative outcome study between LLR and matched-pair open liver resections (OLR). Methods: Sixty five patients underwent attempted LLR from 1998 through 2008; 52 of which were completed laparoscopically. Patients who underwent OLR prior to 1998 were matched to laparoscopic cases for demographics, comorbidities, diagnosis, tumor characteristics, procedure, and background liver. Perioperative and oncologic outcomes were compared between the two groups. Analyses were performed excluding and including conversion cases. Results: Characteristics were comparable between both groups. LLR was associated with significant reductions in estimated blood loss, frequency of transfusion, frequency of Pringle maneuver, postoperative morbidity, time to recovery, length of hospital stay, and incidence of incisional hernia. For patients with malignant tumors, there were no positive surgical margins or local recurrence in either group and the overall pattern of recurrence was similar. Conclusion: For well-selected patients, LLR is a feasible operation that does not compromise operative or oncologic outcomes. While LLR was associated with some benefits, these can only be definitively proven in a randomized controlled trial.
AB - Background: Laparoscopic liver resection (LLR) has become an increasingly popular operation; however, its theoretical benefits remain unproven. The aim of this study was to conduct a comparative outcome study between LLR and matched-pair open liver resections (OLR). Methods: Sixty five patients underwent attempted LLR from 1998 through 2008; 52 of which were completed laparoscopically. Patients who underwent OLR prior to 1998 were matched to laparoscopic cases for demographics, comorbidities, diagnosis, tumor characteristics, procedure, and background liver. Perioperative and oncologic outcomes were compared between the two groups. Analyses were performed excluding and including conversion cases. Results: Characteristics were comparable between both groups. LLR was associated with significant reductions in estimated blood loss, frequency of transfusion, frequency of Pringle maneuver, postoperative morbidity, time to recovery, length of hospital stay, and incidence of incisional hernia. For patients with malignant tumors, there were no positive surgical margins or local recurrence in either group and the overall pattern of recurrence was similar. Conclusion: For well-selected patients, LLR is a feasible operation that does not compromise operative or oncologic outcomes. While LLR was associated with some benefits, these can only be definitively proven in a randomized controlled trial.
KW - Case control study
KW - Laparoscopic liver resection
KW - Minimal invasive surgery
UR - http://www.scopus.com/inward/record.url?scp=71149084565&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=71149084565&partnerID=8YFLogxK
U2 - 10.1007/s11605-009-0993-5
DO - 10.1007/s11605-009-0993-5
M3 - Article
C2 - 19727974
AN - SCOPUS:71149084565
SN - 1091-255X
VL - 13
SP - 2276
EP - 2283
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 12
ER -