Association of laparoscopic surgery with improved perioperative and survival outcomes in patients with resectable intrahepatic cholangiocarcinoma: A systematic seview and meta-analysis from propensity-score matched studies

Background: Recent studies have associated laparoscopic surgery with better overall survival (OS) in patients with hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM). The potential benefits of laparoscopic liver resection (LLR) over open liver resection (OLR) have not been demonst...

Full description

Bibliographic Details
Authors: Aliseda-Jover, D. (Daniel)|||/items/bfa542c5-12cf-4850-959a-d81305d560cd, Sapisochin, G. (Gonzalo)|||/items/690970a4-2693-4be6-9a6f-113ae5f13113, Marti-Cruchaga, P. (Pablo)|||/items/97577c37-4c78-4a17-8b03-55eec0b40ff9, Zozaya-Larequi, G.N. (Gabriel Nicolás)|||/items/edce37f2-5ec6-40e5-996d-57a6e3ca7b0e, Blanco, N. (Nuria)|||/items/98d5610d-0d00-4344-a7e3-ca9e2566cea7, Goh, B.K.P. (Brian K. P.)|||/items/a25c60ec-d9fd-4c21-afbf-c6479badfdcf, Rotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51
Format: article
Publication Date:2023
Country:España
Institution:Universidad de Navarra
Repository:Dadun. Depósito Académico Digital de la Universidad de Navarra
Language:English
OAI Identifier:oai:dadun.unav.edu:10171/67591
Online Access:https://hdl.handle.net/10171/67591
Access Level:Open access
Keyword:Materias Investigacion::Ciencias de la Salud::Oncología
Materias Investigacion::Ciencias de la Salud::Medicina clínica
Materias Investigacion::Ciencias de la Salud::Cirugía
Laparoscopic surgery
Resectable intrahepatic cholangiocarcinoma
Description
Summary:Background: Recent studies have associated laparoscopic surgery with better overall survival (OS) in patients with hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM). The potential benefits of laparoscopic liver resection (LLR) over open liver resection (OLR) have not been demonstrated in patients with intrahepatic cholangiocarcinoma (iCC). Methods: A systematic review of the PubMed, EMBASE, and Web of Science databases was performed to search studies comparing OS and perioperative outcome for patients with resectable iCC. Propensity-score matched (PSM) studies published from database inception to May 1, 2022 were eligible. A frequentist, patient-level, one-stage meta-analysis was performed to analyze the differences in OS between LLR and OLR. Second, intraoperative, postoperative, and oncological outcomes were compared between the two approaches by using a random-effects DerSimonian-Laird model. Results: Six PSM studies involving data from 1.042 patients (530 OLR vs. 512 LLR) were included. LLR in patients with resectable iCC was found to significantly decrease the hazard of death (stratified hazard ratio [HR]: 0.795 [95% confidence interval [CI]: 0.638-0.992]) compared with OLR. Moreover, LLR appears to be significantly associated with a decrease in intraoperative bleeding (- 161.47 ml [95% CI - 237.26 to - 85.69 ml]) and transfusion (OR = 0.41 [95% CI 0.26-0.69]), as well as with a shorter hospital stay (- 3.16 days [95% CI - 4.98 to - 1.34]) and a lower rate of major (Clavien-Dindo ≥III) complications (OR = 0.60 [95% CI 0.39-0.93]). Conclusions: This large meta-analysis of PSM studies shows that LLR in patients with resectable iCC is associated with improved perioperative outcomes and, being conservative, yields similar OS outcomes compared with OLR.

Similar Items