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dc.contributor.authorvan der Heijde, Nicky
dc.contributor.authorRatti, Francesca
dc.contributor.authorAldrighetti, Luca
dc.contributor.authorBenedetti Cacciaguerra, Andrea
dc.contributor.authorCan, Mehmet Fatih
dc.contributor.authorD'Hondt, Mathieu
dc.contributor.authorDi Benedetto, Fabrizio
dc.contributor.authorIvanecz, Arpad
dc.contributor.authorMagistri, Paolo
dc.contributor.authorMenon, Krishna
dc.contributor.authorPapoulas, Michail
dc.contributor.authorVivarelli, Marco
dc.contributor.authorBesselink, Marc G
dc.contributor.authorAbu Hilal, Mohammed
dc.date.accessioned2021-01-15T08:47:50Z
dc.date.available2021-01-15T08:47:50Z
dc.date.issued2020-11-02
dc.identifier.other33140153
dc.identifier.urihttp://hdl.handle.net/20.500.12591/471
dc.description.abstractBackground: Although laparoscopic liver resection has become the standard for minor resections, evidence is lacking for more complex resections such as the right posterior sectionectomy (RPS). We aimed to compare surgical outcomes between laparoscopic (LRPS) and open right posterior sectionectomy (ORPS). Methods: An international multicenter retrospective study comparing patients undergoing LRPS or ORPS (January 2007—December 2018) was performed. Patients were matched based on propensity scores in a 1:1 ratio. Primary endpoint was major complication rate defined as Accordion ≥ 3 grade. Secondary endpoints included blood loss, length of hospital stay (LOS) and resection status. A sensitivity analysis was done excluding the first 10 LRPS patients of each center to correct for the learning curve. Additionally, possible risk factors were explored for operative time, blood loss and LOS. Results: Overall, 399 patients were included from 9 centers from 6 European countries of which 150 LRPS could be matched to 150 ORPS. LRPS was associated with a shorter operative time [235 (195–285) vs. 247 min (195–315) p = 0.004], less blood loss [260 (188–400) vs. 400 mL (280–550) p = 0.009] and a shorter LOS [5 (4–7) vs. 8 days (6–10), p = 0.002]. Major complication rate [n = 8 (5.3%) vs. n = 9 (6.0%) p = 1.00] and R0 resection rate [144 (96.0%) vs. 141 (94.0%), p = 0.607] did not differ between LRPS and ORPS, respectively. The sensitivity analysis showed similar findings in the previous mentioned outcomes. In multivariable regression analysis blood loss was significantly associated with the open approach, higher ASA classification and malignancy as diagnosis. For LOS this was the open approach and a malignancy. Conclusion: This international multicenter propensity score-matched study showed an advantage in favor of LRPS in selected patients as compared to ORPS in terms of operative time, blood loss and LOS without differences in major complications and R0 resection rate. © 2020, The Author(s).en_US
dc.language.isoengen_US
dc.publisherTıp Fakültesien_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/us/*
dc.subjectLaparoscopic surgeryen_US
dc.subjectLiver surgeryen_US
dc.subjectMinimally invasive surgeryen_US
dc.subjectOperative outcomesen_US
dc.subjectPropensity score matchingen_US
dc.subjectSurgical procedureen_US
dc.titleLaparoscopic versus open right posterior sectionectomy: an international, multicenter, propensity score-matched evaluation.en_US
dc.typeinfo:eu-repo/semantics/articleen_US
dc.contributor.departmentCerrahi Tıp Bilimlerien_US


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