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
Efanov, Mikhail
Salimgereeva, Diana
Alikhanov, Ruslan
Wu, Andrew G R
Geller, David
Cipriani, Federica
Aghayan, Davit L
Fretland, Asmund Avdem
Sijberden, Jasper
Belli, Andrea
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2022-07-20
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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.
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Efanov M, Salimgereeva D, Alikhanov R, Wu AGR, Geller D, Cipriani F, Aghayan DL, Fretland AA, Sijberden J, Belli A, Marino MV, Mazzaferro V, Chiow AKH, Sucandy I, Ivanecz A, Choi SH, Lee JH, Prieto M, Vivarelli M, Giuliante F, Ruzzenente A, Yong CC, Fondevila C, Rotellar F, Choi GH, Robless Campos R, Wang X, Sutcliffe RP, Pratschke J, Lai E, Chong CC, D'Hondt M, Monden K, Lopez-Ben S, Herman P, Di Benedetto F, Kingham TP, Liu R, Long TCD, Ferrero A, Levi Sandri GB, Cherqui D, Scatton O, Wakabayashi G, Troisi RI, Cheung TT, Sugioka A, Han HS, Abu Hilal M, Soubrane O, Fuks D, Aldrighetti L, Edwin B, Goh BKP; International Robotic and Laparoscopic Liver Resection Study Group Investigators. 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. J Hepatobiliary Pancreat Sci. 2023 Feb;30(2):177-191. doi: 10.1002/jhbp.1210. Epub 2022 Jul 20
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