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...
| Autores: | , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2023 |
| País: | España |
| Institución: | Universidad de Navarra |
| Repositorio: | Dadun. Depósito Académico Digital de la Universidad de Navarra |
| Idioma: | inglés |
| OAI Identifier: | oai:dadun.unav.edu:10171/67591 |
| Acceso en línea: | https://hdl.handle.net/10171/67591 |
| Access Level: | acceso abierto |
| Palabra clave: | 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 |
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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 studiesAliseda-Jover, D. (Daniel)|||/items/bfa542c5-12cf-4850-959a-d81305d560cdSapisochin, G. (Gonzalo)|||/items/690970a4-2693-4be6-9a6f-113ae5f13113Marti-Cruchaga, P. (Pablo)|||/items/97577c37-4c78-4a17-8b03-55eec0b40ff9Zozaya-Larequi, G.N. (Gabriel Nicolás)|||/items/edce37f2-5ec6-40e5-996d-57a6e3ca7b0eBlanco, N. (Nuria)|||/items/98d5610d-0d00-4344-a7e3-ca9e2566cea7Goh, B.K.P. (Brian K. P.)|||/items/a25c60ec-d9fd-4c21-afbf-c6479badfdcfRotellar-Sastre, F. (Fernando)|||/items/833cb788-f4b9-404d-a18b-ae1c84369b51Materias Investigacion::Ciencias de la Salud::OncologíaMaterias Investigacion::Ciencias de la Salud::Medicina clínicaMaterias Investigacion::Ciencias de la Salud::CirugíaLaparoscopic surgeryResectable intrahepatic cholangiocarcinomaBackground: 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.SpringerDadun. Depósito Académico Digital Universidad de Navarra20232023-10-0520232023-01-0120232023-01-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/67591reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/675912026-06-21T12:47:57Z |
| dc.title.none.fl_str_mv |
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 |
| title |
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 |
| spellingShingle |
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 Aliseda-Jover, D. (Daniel)|||/items/bfa542c5-12cf-4850-959a-d81305d560cd 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 |
| title_short |
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 |
| title_full |
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 |
| title_fullStr |
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 |
| title_full_unstemmed |
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 |
| title_sort |
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 |
| dc.creator.none.fl_str_mv |
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 |
| author |
Aliseda-Jover, D. (Daniel)|||/items/bfa542c5-12cf-4850-959a-d81305d560cd |
| author_facet |
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 |
| author_role |
author |
| author2 |
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 |
| author2_role |
author author author author author author |
| dc.contributor.none.fl_str_mv |
Dadun. Depósito Académico Digital Universidad de Navarra |
| dc.subject.none.fl_str_mv |
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 |
| topic |
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 |
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. |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023 2023-10-05 2023 2023-01-01 2023 2023-01-01 |
| dc.type.none.fl_str_mv |
journal article http://purl.org/coar/resource_type/c_6501 |
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info:eu-repo/semantics/article |
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article |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/10171/67591 |
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https://hdl.handle.net/10171/67591 |
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Inglés eng |
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Inglés |
| language |
eng |
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open access http://purl.org/coar/access_right/c_abf2 |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 |
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openAccess |
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application/pdf |
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Springer |
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Springer |
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reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra instname:Universidad de Navarra |
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Universidad de Navarra |
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Dadun. Depósito Académico Digital de la Universidad de Navarra |
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Dadun. Depósito Académico Digital de la Universidad de Navarra |
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