Minimally invasive versus open radical resection surgery for hilar cholangiocarcinoma: Comparable outcomes associated with advantages of minimal invasiveness

Autor: Jian-Guo Qiu, Xin Deng, Jia-Rui Liu, Wei Tang, Shan-Shan Liu, Luo Cheng, Cheng-You Du
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Blood transfusion
medicine.medical_treatment
Cancer Treatment
Blood Loss
Surgical
Bile leakage
Mathematical and Statistical Techniques
Postoperative Complications
Robotic Surgical Procedures
Medicine and Health Sciences
Multidisciplinary
Statistics
Metaanalysis
Tumor Resection
Hospitals
Surgical Oncology
Oncology
Physical Sciences
Medicine
Radical resection
Research Article
Clinical Oncology
medicine.medical_specialty
Science
Surgical and Invasive Medical Procedures
Minimally Invasive Surgery
Research and Analysis Methods
Text mining
Blood loss
medicine
Humans
Minimally Invasive Surgical Procedures
Statistical Methods
Surgical Resection
business.industry
Open surgery
Length of Stay
Confidence interval
Surgery
Health Care
Bile Duct Neoplasms
Health Care Facilities
Severe morbidity
Laparoscopy
Health Statistics
Morbidity
Clinical Medicine
business
Mathematics
Klatskin Tumor
Zdroj: PLoS ONE
PLoS ONE, Vol 16, Iss 3, p e0248534 (2021)
ISSN: 1932-6203
Popis: Background Minimally invasive surgery (MIS) provides a new approach for patients with hilar cholangiocarcinoma (HCCA). However, whether it can achieve similar outcomes to traditional open surgery (OS) remains controversial. Methods To assess the safety and feasibility of MIS for HCCA, a systematic review and meta-analysis was performed to compare the outcomes of MIS with OS. Seventeen outcomes were assessed. Results Nine studies involving 382 patients were included. MIS was comparable in blood transfusion rate, R0 resection rate, lymph nodes received, overall morbidity, severe morbidity (Clavien–Dindo classification > = 3), bile leakage rate, wound infection rate, intra-abdominal infection rate, days until oral feeding, 1-year overall survival, 2-year overall survival and postoperative mortality with OS. Although operation time was longer (mean difference (MD) = 93.51, 95% confidence interval (CI) = 64.10 to 122.91, P < 0.00001) and hospital cost (MD = 0.68, 95% CI = 0.03 to 1.33, P = 0.04) was higher in MIS, MIS was associated with advantages of minimal invasiveness, that was less blood loss (MD = -81.85, 95% CI = -92.09 to -71.62, P < 0.00001), less postoperative pain (MD = -1.21, 95% CI = -1.63 to -0.79, P < 0.00001), and shorter hospital stay (MD = -4.22, 95% CI = -5.65 to -2.80, P < 0.00001). Conclusions The safety and feasibility of MIS for HCCA is acceptable in selected patients. MIS is a remarkable alternative to OS for providing comparable outcomes associated with a benefit of minimal invasiveness and its application should be considered more.
Databáze: OpenAIRE
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