Minimally invasive versus open right hepatectomy: comparative study with propensity score matching analysis

Abstract Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs) Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, overall morbidity or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe in experienced hands. Minimally invasive approach was associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

10.21203/rs.3.rs-37327/v1 ◽

2020 ◽

Author(s):

Vinicius Campos Duarte ◽

Fabricio Coelho ◽

Alain Valverde ◽

Divia Danoussou ◽

Jaime Kruger ◽

...

Keyword(s):

Propensity Score ◽

Blood Loss ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Liver Tumors ◽

Perioperative Complications ◽

Resection Margins ◽

Long Term Outcomes ◽

Invasive Approach

Abstract Background Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P = 0.01), lower rate of minor complications (13.5% vs. 35%, P = 0.03) and larger resection margins (10 mm vs. 5 mm, P = 0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P = 0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P = 0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P = 0.09) and liver metastasis (P = 0.80). Conclusions MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

10.21203/rs.3.rs-37327/v4 ◽

2020 ◽

Author(s):

Vinicius Campos Duarte ◽

Fabricio Coelho ◽

Alain Valverde ◽

Divia Danoussou ◽

Jaime Kruger ◽

...

Keyword(s):

Propensity Score ◽

Blood Loss ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Liver Tumors ◽

Perioperative Complications ◽

Resection Margins ◽

Long Term Outcomes ◽

Invasive Approach

Abstract Background: Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods: Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. Results: During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P=0.01), lower rate of minor complications (13.5% vs. 35%, P=0.03) and larger resection margins (10 mm vs. 5 mm, P=0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P=0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, overall morbidity or perioperative mortality were observed. OS was similar between the groups (P=0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P=0.09) and liver metastasis (P=0.80). Conclusions: MIRHs are feasible and safe in experienced hands. Minimally invasive approach was associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

10.21203/rs.3.rs-37327/v2 ◽

2020 ◽

Author(s):

Vinicius Campos Duarte ◽

Fabricio Coelho ◽

Alain Valverde ◽

Divia Danoussou ◽

Jaime Kruger ◽

...

Keyword(s):

Propensity Score ◽

Blood Loss ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Liver Tumors ◽

Perioperative Complications ◽

Resection Margins ◽

Long Term Outcomes ◽

Invasive Approach

Abstract Background: Minimally invasive liver resections (MILRs) have been increasingly performed in recent years. However, the majority of MILRs are actually minor or limited resections of peripheral lesions. Due to the technical complexity major hepatectomies remain challenging for minimally invasive surgery. The aim of this study was to compare the short and long-term outcomes of patients undergoing minimally invasive right hepatectomies (MIRHs) with contemporary patients undergoing open right hepatectomies (ORHs). Methods: Consecutive patients submitted to anatomic right hepatectomies between January 2013 and December 2018 in two tertiary referral centers were studied. Study groups were compared on an intention-to-treat basis after propensity score matching (PSM). Overall survival (OS) analyses were performed for the entire cohort and specific etiologies subgroups. \Results: During study period 178 right hepatectomies were performed. After matching, 37 patients were included in MIRH group and 60 in ORH group. The groups were homogenous for all baseline characteristics. MIRHs had significant lower blood loss (400 ml vs. 500 ml, P=0.01), lower rate of minor complications (13.5% vs. 35%, P=0.03) and larger resection margins (10 mm vs. 5 mm, P=0.03) when compared to ORHs. Additionally, a non-significant decrease in hospital stay (ORH 9 days vs. MIRH 7 days, P=0.09) was observed. No differences regarding the use of Pringle’s maneuver, operative time, major complications or perioperative mortality were observed. OS was similar between the groups (P=0.13). Similarly, no difference in OS was found in subgroups of patients with primary liver tumors (P=0.09) and liver metastasis (P=0.80). \Conclusions: MIRHs are feasible and safe. Minimally invasive approach is associated with less blood loss, a significant reduction in minor perioperative complications, and did not negatively affect long-term outcomes.

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Minimally invasive versus open right hepatectomy: Comparative study with propensity score matching analysis

10.21203/rs.3.rs-37327/v3 ◽

2020 ◽

Author(s):

Vinicius Campos Duarte ◽

Fabricio Coelho ◽

Alain Valverde ◽

Divia Danoussou ◽

Jaime Kruger ◽

...

Keyword(s):

Propensity Score ◽

Blood Loss ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Liver Tumors ◽

Perioperative Complications ◽

Resection Margins ◽

Long Term Outcomes ◽

Invasive Approach

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Effect of surgical start time on short- and long-term outcomes after minimally invasive esophagectomy: a propensity-score matching analysis

Diseases of the Esophagus ◽

10.1093/dote/doaa108 ◽

2020 ◽

Author(s):

Tao Bao ◽

Xiao-Long Zhao ◽

Kun-Kun Li ◽

Ying-Jian Wang ◽

Wei Guo

Keyword(s):

Propensity Score ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Survival Rates ◽

Disease Free Survival ◽

Long Term Outcomes ◽

Start Time ◽

Short And Long Term ◽

Mckeown Esophagectomy

Summary There is growing focus on the relationship between surgical start time and postoperative outcomes. However, the extent to which the operation start time affects the surgical and oncological outcomes of patients undergoing esophagectomy has not previously been studied. The purpose of this retrospective study was to investigate the potential effect of surgical start time on the short- and long-term outcomes for patients who underwent thoracoscopic–laparoscopic McKeown esophagectomy. From September 2009 to June 2019, a total of 700 consecutive patients suffering from esophageal cancer underwent thoracoscopic–laparoscopic McKeown esophagectomy in the Department of Thoracic Surgery at Daping Hospital. Among these patients, 166 esophagectomies were performed on the same day and were classified as the first- or second-start group. Patients in the first-start group were more likely to be older than those in the second-start group: (64.73 vs. 61.28, P = 0.002). In addition, patients with diabetes mellitus were more likely to be first-start cases (8.4 vs. 1.2%). After propensity score matching (52 matched patients in first-start cases and 52 matched patients in second-start cases), these findings were no longer statistically significant. There was no difference in the incidence rate of peri- or postoperative adverse events between the first- and second-start groups. The disease-specific survival rates and disease-free survival rates were comparable between the two groups (P = 0.236 and 0.292, respectively). On the basis of the present results, a later start time does not negatively affect the short- or long-term outcomes of patients undergoing minimally invasive McKeown esophagectomy.

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Comparison of Long-term outcomes between Lynch sydrome and sporadic colorectal cancer: a propensity score matching analysis

10.21203/rs.3.rs-130271/v1 ◽

2020 ◽

Author(s):

Yun Xu ◽

Cong Li ◽

Charlie Zhi-Lin Zheng ◽

Yu-Qin Zhang ◽

Tian-An Guo ◽

...

Keyword(s):

Colorectal Cancer ◽

Propensity Score ◽

Propensity Score Matching ◽

Control Group ◽

Sporadic Colorectal Cancer ◽

Long Term Outcomes ◽

Term Survival ◽

Long Term Survival ◽

Tumor Stages

Abstract Background Lynch syndrome (LS) is the most common hereditary colorectal cancer (CRC) syndrome. Comparison of prognosis between LS and sporadic CRC (SCRC) were rare,with conflicting results. This study aimed to compare the long-term outcomes between patients with LS and SCRC. Methods Between June 2008 and September 2018, a total of 47 patients were diagnosed with LS by genetic testing at Fudan University Shanghai Cancer Center. A 1:2 propensity score matching was performed to obtain homogeneous cohorts from SCRC group. Thereafter, 94 SCRC patients were enrolled as control group. The long-term survival rates between the two groups were compared, and the prognostic factors were also analyzed. Results The 5-year OS rate of LS group was 97.6%, which was significantly higher than of 82.6% for SCRC group (p = 0.029). The 5-year PFS rate showed no significant differences between the two groups (78.0% for LS group vs. 70.6% for SCRC patients; p = 0.262). The 5-year TFS rates in LS group was 62.1% for LS patients, which were significantly lower than of 70.6% for SCRC group (p = 0.039). By multivariate analysis, we found that tumor progression of primary CRC and TNM staging were independent risk factors for OS. Conclusion LS patients have better long-term survival prognosis than SCRC patients. Strict regular follow-up monitoring, detection at earlier tumor stages, and effective treatment are key to ensuring better long-term prognosis.

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Perioperative and long-term outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma with well-preserved liver function and cirrhotic background: a propensity score matching study

Surgical Endoscopy ◽

10.1007/s00464-018-6296-8 ◽

2018 ◽

Vol 33 (1) ◽

pp. 206-215 ◽

Cited By ~ 12

Author(s):

Xinqiang Wu ◽

Zejian Huang ◽

Wan Yee Lau ◽

Wenda Li ◽

Pai Lin ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Propensity Score ◽

Liver Function ◽

Propensity Score Matching ◽

Long Term Outcomes ◽

Open Liver Resection

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Transorbital Endoscopic Surgery for Sphenoid Wing Meningioma: Long-Term Outcomes and Surgical Technique

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1713854 ◽

2020 ◽

Vol 81 (04) ◽

pp. 357-368

Author(s):

N. Goncalves ◽

D.E. Lubbe

Keyword(s):

Minimally Invasive ◽

Endoscopic Surgery ◽

Case Series ◽

Surgical Approaches ◽

Benign Tumors ◽

Long Term Outcomes ◽

Invasive Approach ◽

Visual Outcomes ◽

Presenting Symptoms

AbstractSphenoid wing meningiomas are benign tumors that can result in proptosis, visual impairment, and pain. Traditional open surgical approaches are associated with significant morbidity. Transorbital endoscopic surgery has been developed as a minimally invasive approach to gain access to these tumors and address the main presenting symptoms. Case series reporting transorbital endoscopic resection of sphenoid wing meningiomas using combined endonasal, pre-caruncular, and extended superior eyelid approaches have demonstrated stable and/or improved short- and medium-term visual outcomes. Earlier medial optic nerve decompression appears to result in more favorable long-term visual outcomes. Transorbital endoscopic surgery therefore represents an emerging minimally invasive alternative to deal with these challenging lesions.

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