Fabricio F Coelho1, Wanderley M Bernardo2, Jaime A P Kruger3, Vagner B Jeismann4, Gilton M Fonseca1, Rodrigo L Macacari1, Danielle M Cesconetto1, Luiz A C D'Albuquerque5, Ivan Cecconello1, Paulo Herman1. 1. Digestive Surgery Division, Department of Gastroenterology, University of São Paulo Medical School, Sao Paulo, Brazil. 2. University of Sao Paulo Medical School, Sao Paulo, Brazil. 3. Digestive Surgery Division, Department of Gastroenterology, University of São Paulo Medical School, Sao Paulo, Brazil; Digestive Surgery Division, Department of Gastroenterology, Instituto do Câncer do Estado de Sao Paulo (ICESP), Sao Paulo, Brazil. 4. Digestive Surgery Division, Department of Gastroenterology, University of São Paulo Medical School, Sao Paulo, Brazil; Digestive Surgery Division, Department of Gastroenterology, Instituto do Câncer do Estado de Sao Paulo (ICESP), Sao Paulo, Brazil. Electronic address: vjeismann@gmail.com. 5. Liver and Gastrointestinal Transplant Division, Department of Gastroenterology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
Abstract
BACKGROUND: Laparoscopy-assisted (hybrid) liver surgery is considered a minimally invasive technique, however there are doubts regarding loss of the benefits of laparoscopy due to the use of an auxiliary incision. The aim of this study was to compare perioperative results of hybrid vs. open and hybrid vs. pure laparoscopic approach to liver resection for focal lesions and living donation. METHODS: A systematic review was performed in Medline, EMBASE, Cochrane Library Central and LILACS databases. Perioperative outcomes were analyzed. RESULTS: 21 studies were included. Hybrid vs. open: operative time was lower in open group (mean difference [MD] = 34 min; 95%CI: 22-47; P < 0.001; N = 669). Hybrid technique was associated with a reduction in operative blood loss [MD = -43 ml; 95%CI: -74-(-13); P = 0.005, N = 1738]; shorter hospital stay [MD = -1.9 days; 95%CI: -3.2-(-0.5); P = 0.008; N = 833] and lower morbidity [risk difference (RD) = -0.05; 95%CI: -0.10-(-0.01); P = 0.010; N = 1359]. Hybrid vs. pure laparoscopic: There was no difference regarding blood loss, transfusion rate, hospital stay and morbimortality. DISCUSSION: Hybrid technique had perioperative outcomes that were more in keeping with pure laparoscopic outcomes than open surgery. Hybrid liver surgery should be considered a minimally invasive approach.
BACKGROUND: Laparoscopy-assisted (hybrid) liver surgery is considered a minimally invasive technique, however there are doubts regarding loss of the benefits of laparoscopy due to the use of an auxiliary incision. The aim of this study was to compare perioperative results of hybrid vs. open and hybrid vs. pure laparoscopic approach to liver resection for focal lesions and living donation. METHODS: A systematic review was performed in Medline, EMBASE, Cochrane Library Central and LILACS databases. Perioperative outcomes were analyzed. RESULTS: 21 studies were included. Hybrid vs. open: operative time was lower in open group (mean difference [MD] = 34 min; 95%CI: 22-47; P < 0.001; N = 669). Hybrid technique was associated with a reduction in operative blood loss [MD = -43 ml; 95%CI: -74-(-13); P = 0.005, N = 1738]; shorter hospital stay [MD = -1.9 days; 95%CI: -3.2-(-0.5); P = 0.008; N = 833] and lower morbidity [risk difference (RD) = -0.05; 95%CI: -0.10-(-0.01); P = 0.010; N = 1359]. Hybrid vs. pure laparoscopic: There was no difference regarding blood loss, transfusion rate, hospital stay and morbimortality. DISCUSSION: Hybrid technique had perioperative outcomes that were more in keeping with pure laparoscopic outcomes than open surgery. Hybrid liver surgery should be considered a minimally invasive approach.
Authors: Eddy P Lincango Naranjo; Estefany Garces-Delgado; Timo Siepmann; Lutz Mirow; Paola Solis-Pazmino; Harold Alexander-Leon; Gabriela Restrepo-Rodas; Rafael Mancero-Montalvo; Cristina J Ponce; Ramiro Cadena-Semanate; Ronnal Vargas-Cordova; Glenda Herrera-Cevallos; Sebastian Vallejo; Carolina Liu-Sanchez; Larry J Prokop; Ioannis A Ziogas; Michail G Vailas; Alfredo D Guerron; Brendan C Visser; Oscar J Ponce; Andrew S Barbas; Dimitrios Moris Journal: J Clin Med Date: 2022-05-05 Impact factor: 4.964
Authors: Bruno Silva de Assis; Fabricio Ferreira Coelho; Vagner Birk Jeismann; Jaime Arthur Pirola Kruger; Gilton Marques Fonseca; Ivan Cecconello; Paulo Herman Journal: Arq Bras Cir Dig Date: 2020-05-18