Background Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.

Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study / Efanov, Mikhail; Salimgereeva, Diana; Alikhanov, Ruslan; Wu, Andrew G R; Geller, David; Cipriani, Federica; Aghayan, Davit L; Fretland, Asmund Avdem; Sijberden, Jasper; Belli, Andrea; Marino, Marco V; Mazzaferro, Vincenzo; Chiow, Adrian K H; Sucandy, Iswanto; Ivanecz, Arpad; Choi, Sung Hoon; Lee, Jae Hoon; Prieto, Mikel; Vivarelli, Marco; Giuliante, Felice; Ruzzenente, Andrea; Yong, Chee-Chien; Fondevila, Constantino; Rotellar, Fernando; Choi, Gi-Hong; Robless Campos, Ricardo; Wang, Xiaoying; Sutcliffe, Robert P; Pratschke, Johann; Lai, Eric; Chong, Charing C; D'Hondt, Mathieu; Monden, Kazuteru; Lopez-Ben, Santiago; Herman, Paulo; Di Benedetto, Fabrizio; Kingham, T Peter; Liu, Rong; Long, Tran Cong Duy; Ferrero, Alessandro; Levi Sandri, Giovanni Battista; Cherqui, Daniel; Scatton, Olivier; Wakabayashi, Go; Troisi, Roberto I; Cheung, Tan-To; Sugioka, Atsushi; Han, Ho-Seong; Abu Hilal, Mohammad; Soubrane, Olivier; Fuks, David; Aldrighetti, Luca; Edwin, Bjorn; Goh, Brian K P. - In: JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES. - ISSN 1868-6974. - 30:2(2023), pp. 177-191. [10.1002/jhbp.1210]

Comparison between the difficulty of laparoscopic limited liver resections of tumors located in segment 7 versus segment 8: An international multicenter propensity-score matched study

Vivarelli, Marco;
2023-01-01

Abstract

Background Presently, according to different difficulty scoring systems, there is no difference in complexity estimation of laparoscopic liver resection (LLR) of segments 7 and 8. However, there is no published data supporting this assumption. To date, no studies have compared the outcomes of laparoscopic parenchyma-sparing resection of the liver segments 7 and 8. Methods A post hoc analysis of patients undergoing LLR of segments 7 and 8 in 46 centers between 2004 and 2020 was performed. 1:1 Propensity score matching (PSM) was used to compare isolated LLR of segments 7 and 8. Subset analyses were also performed to compare atypical resections and segmentectomies of 7 and 8. Results A total of 2411 patients were identified, and 1691 patients met the inclusion criteria. Comparison after PSM between the entire cohort of segment 7 and segment 8 resections revealed inferior results for segment 7 resection in terms of increased blood loss, blood transfusions, and conversions to open surgery. Subset analyses of only atypical resections similarly demonstrated poorer outcomes for segment 7 in terms of increased blood loss, operation time, blood transfusions, and conversions to open surgery. Conversely, a subgroup analysis of segmentectomies after PSM found better outcomes for segment 7 in terms of a shorter operation time and hospital stay. Conclusion Differences in the outcomes of segments 7 and 8 resections suggest a greater difficulty of laparoscopic atypical resection of segment 7 compared to segment 8, and greater difficulty of segmentectomy 8 compared to segmentectomy 7.
2023
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11566/321599
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