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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

Autores: Efanov, M.; Salimgereeva, D.; Alikhanov, R.; Wu, A. G. R.; Geller, D.; Cipriani, F.; Aghayan, D. L.; Fretland, A. A.; Sijberden, J.; Belli, A.; Marino, M. V.; Mazzaferro, V.; Chiow, A. K. H.; Sucandy, I.; Ivanecz, A.; Choi, S. H.; Lee, J. H.; Prieto, M.; Vivarelli, M.; Giuliante, F.; Ruzzenente, A.; Yong, C. C.; Fondevila, C.; Rotellar Sastre, Fernando; Choi, G. H.; Robless Campos, R.; Wang, X.; Sutcliffe, R. P.; Pratschke, J.; Lai, E.; Chong, C. C.; D'Hondt, M.; Monden, K.; López-Ben, S.; Herman, P.; Di Benedetto, F.; Kingham, T. P.; Liu, R.; Long, T. C. D.; Ferrero, A.; Levi Sandri, G. B.; Cherqui, D.; Scatton, O.; Wakabayashi, G.; Troisi, R. I.; Cheung, T. T.; Sugioka, A.; Han, H. S.; Abu Hilal, M.; Soubrane, O.
ISSN: 1868-6974
Volumen: 30
Número: 2
Páginas: 177 - 191
Fecha de publicación: 2023
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.