Anterior vs conventional approach hepatectomy for large liver cancer: a meta-analysis.

Abstract:

AIM:To evaluate the clinical outcomes and safety of anterior- and conventional-approach hepatectomy for patients with large liver tumors. METHODS:PubMed, EMBASE, Google Scholar and the Cochrane Library databases were searched for randomized controlled trials (RCTs) and controlled clinical trials comparing anterior-approach hepatectomy (AAH) and conventional-approach hepatectomy (CAH). Two observers independently extracted the data using a spreadsheet and assessed the studies for inclusion. Studies that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed using either fixed effects or random effects models. RESULTS:Two RCTs and six controlled clinical trials involving 807 patients met the predefined inclusion criteria. A total of 363 patients underwent AAH and 444 underwent CAH. Meta-analysis indicated that the AAH group had fewer requirements for transfusion (OR = 0.37, 95%CI: 0.21-0.63), less recurrence (OR = 0.57, 95%CI: 0.37-0.87), and lower mortality (OR = 0.29, 95%CI: 0.13-0.63). There were no significant differences between AAH and CAH with regard to perioperative complications (OR = 0.94, 95%CI: 0.58-1.51), intraoperative tumor rupture (OR = 0.98, 95%CI: 0.40-2.40), or length of hospital stay (weighted mean difference = -0.17, 95%CI: -2.36-2.02). CONCLUSION:AAH has advantages of decreased transfusion, mortality and recurrence compared to CAH. It is a safe and effective method for large cancers requiring right hepatectomy.

journal_name

World J Gastroenterol

authors

Li L,Wang HQ,Wang Q,Yang J,Yang JY

doi

10.3748/wjg.v20.i45.17235

subject

Has Abstract

pub_date

2014-12-07 00:00:00

pages

17235-43

issue

45

eissn

1007-9327

issn

2219-2840

journal_volume

20

pub_type

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