Are Hybrid Liver Resections Truly Minimally Invasive? A Propensity Score Matching Analysis

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Fabricio Ferreira CoelhoPaulo Herman

Abstract

Hybrid liver resection is considered a modality of minimally invasive surgery; however, there are doubts regarding loss of benefits of laparoscopy due to the use of an auxiliary incision. We compared perioperative results of patients undergoing hybrid × open and hybrid × pure laparoscopic resections. Consecutive patients undergoing liver resection between June 2008 and January 2016 were studied. Study groups were compared after propensity score matching (PSM). Six hundred forty-four resections were included in the comparative analysis: 470 open, 120 pure laparoscopic, and 54 hybrids. After PSM, 54 patients were included in each group. Hybrid × open: hybrid technique had shorter operative time (319.5 ± 108.6 × 376.2 ± 155.8 minutes, P = .033), shorter hospital stay (6.0 ± 2.7 × 8.1 ± 5.6 days, P = .001), and lower morbidity (18.5% × 40.7%, P = .003). Hybrid × pure laparoscopic: hybrid group had lower conversion rate (0% × 13%, P = .013). There was no difference regarding estimated blood loss, transfusion rate, hospital stay, complications, or mortality. Hybrid resection has better perioperative results than the open approach and is similar to pure laparoscopy. The hybrid technique should be considered a minimally invasive approach.

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Dec 10, 2015·Revista do Colégio Brasileiro de Cirurgiões·Fabricio Ferreira CoelhoPaulo Herman
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Citations

May 20, 2020·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Bruno Silva de AssisPaulo Herman
Nov 1, 2020·BMC Surgery·Vinícius Campos DuarteRenato Micelli Lupinacci

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