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Introduction: To compare the outcomes of pure laparoscopic left hemihepatectomy (LLH) versus open left hemihepatectomy (OLH) for benign and malignant conditions using multivariate analysis.

Materials and Methods: All consecutive cases of LLH and OLH between October 2007 and December 2013 in a tertiary referral hospital were enrolled in this retrospective cohort study. All surgical procedures were performed by one surgeon. The LLH and OLH groups were compared in terms of patient demographics, preoperative data, clinical perioperative outcomes, and tumor characteristics in patients with malignancy. Multivariate analysis of the prognostic factors associated with severe complications was then performed.

Results: The LLH group (n = 62) had a significantly shorter postoperative hospital stay than the OLH group (n = 118) (9.53 ± 3.30 vs 14.88 ± 11.36 days, p < 0.001). Multivariate analysis revealed that the OLH group had >4 times the risk of the LLH group in terms of developing severe complications (Clavien-Dindo grade ≥III) (odds ratio 4.294, 95% confidence intervals 1.165-15.832, p = 0.029).

Discussion: LLH was a safe and feasible procedure for selected patients. LLH required shorter hospital stay and resulted in less operative blood loss. Multivariate analysis revealed that LLH was associated with a lower risk of severe complications compared to OLH. The authors suggest that LLH could be a reasonable treatment option for selected patients.

Titel:	Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study.
Autor/in / Beteiligte Person:	Cho, HD ; Kim, KH ; Hwang, S ; Ahn, CS ; Moon, DB ; Ha, TY ; Song, GW ; Jung, DH ; Park, GC ; Lee, SG
Link:	View record at Springer (Volltext)
Zeitschrift:	Surgical endoscopy, Jg. 32 (2018-02-01), Heft 2, S. 643-650
Veröffentlichung:	1992- : New York : Springer ; <i>Original Publication</i>: [Berlin] : Springer International, c1987-, 2018
Medientyp:	academicJournal
ISSN:	1432-2218 (electronic)
DOI:	10.1007/s00464-017-5714-7
Schlagwort:	Aged Blood Loss, Surgical Female Hepatectomy adverse effects Humans Laparoscopy adverse effects Length of Stay Liver Diseases surgery Liver Neoplasms surgery Male Middle Aged Multivariate Analysis Postoperative Complications etiology Retrospective Studies Tertiary Care Centers Treatment Outcome Hepatectomy methods Laparoscopy methods
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Comparative Study; Journal Article Language: English [Surg Endosc] 2018 Feb; Vol. 32 (2), pp. 643-650. <i>Date of Electronic Publication: </i>2017 Jul 21. MeSH Terms: Hepatectomy / methods ; Laparoscopy / methods ; Aged ; Blood Loss, Surgical ; Female ; Hepatectomy / adverse effects ; Humans ; Laparoscopy / adverse effects ; Length of Stay ; Liver Diseases / surgery ; Liver Neoplasms / surgery ; Male ; Middle Aged ; Multivariate Analysis ; Postoperative Complications / etiology ; Retrospective Studies ; Tertiary Care Centers ; Treatment Outcome References: Langenbecks Arch Surg. 2014 Dec;399(8):1039-45. (PMID: 25366357) ; Ann Surg. 2009 Nov;250(5):825-30. (PMID: 19916210) ; Am J Surg. 2005 Feb;189(2):190-4. (PMID: 15720988) ; Trials. 2012 May 06;13:54. (PMID: 22559239) ; World J Hepatol. 2013 Sep 27;5(9):487-95. (PMID: 24073300) ; Int J Med Sci. 2014 Jan 02;11(2):127-33. (PMID: 24465157) ; J Gastrointest Surg. 2008 Mar;12(3):457-62. (PMID: 17701265) ; J Minim Access Surg. 2014 Jul;10(3):107-12. (PMID: 25013325) ; Surgery. 2004 Oct;136(4):804-11. (PMID: 15467665) ; Br J Surg. 2002 Jul;89(7):870-6. (PMID: 12081736) ; J Am Coll Surg. 2014 May;218(5):929-39. (PMID: 24680574) ; Arch Surg. 2003 Jul;138(7):763-9; discussion 769. (PMID: 12860758) ; BMC Surg. 2009 Sep 07;9:14. (PMID: 19735573) ; Surg Endosc. 2013 Aug;27(8):2721-6. (PMID: 23436090) ; Br J Surg. 2011 Sep;98(9):1302-8. (PMID: 21717424) ; Gynecol Oncol. 2003 Oct;91(1):179-89. (PMID: 14529679) ; J Gastrointest Surg. 2011 May;15(5):818-23. (PMID: 21380633) ; Am J Surg. 2009 Aug;198(2):173-7. (PMID: 19268902) ; Eur J Surg Oncol. 2008 Dec;34(12 ):1285-8. (PMID: 18316171) ; Obstet Gynecol. 1991 Nov;78(5 Pt 2):956-8. (PMID: 1833688) ; Ann Surg. 2004 Aug;240(2):205-13. (PMID: 15273542) ; J Hepatobiliary Pancreat Sci. 2011 Jan;18(1):103-5. (PMID: 20552231) ; J Am Coll Surg. 2003 Feb;196(2):236-42. (PMID: 12595052) ; HPB (Oxford). 2014 Feb;16(2):183-7. (PMID: 23600942) ; Ann Surg. 2009 Aug;250(2):187-96. (PMID: 19638912) Contributed Indexing: Keywords: Comparative study; Multivariate analysis; Open left hemihepatectomy; Pure laparoscopic left hemihepatectomy Entry Date(s): Date Created: 20170723 Date Completed: 20190516 Latest Revision: 20220321 Update Code: 20231215

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Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study.