Comparison of laparoscopic liver resection for lesions located in anterolateral and posterosuperior segments: a meta-analysis

Abstract

Background: Laparoscopic liver resection (LLR) is mostly performed to treat benign lesions at easily accessible locations. With improvements in instruments and accumulation of experience, LLR has evolved to treat malignant tumors with major hepatectomy, even in less accessible locations, without compromising the principles of safety and oncology. The present meta-analysis aimed to compare the outcomes of LLR for lesions located in anterolateral (AL) (II, III, IVb, V, and VI) and posterosuperior (PS) (I, IVa, VII, and VIII) liver segments. Methods: A comprehensive search was conducted to identify all eligible studies. This meta-analysis was performed using the STATA 12.0 statistical software. Standardized mean differences (SMDs) and odds ratios (ORs) were calculated for continuous variables and dichotomous variables, respectively, with 95% confidence intervals (CIs). Results: A total of 846 patients from five studies were identified for the final analysis, with 565 patients in the AL group and 281 in the PS group. Although the operation time (SMD −0.60; 95% CI −0.75 to −0.45; P = 0.000) and conversion rate (OR 0.40; 95% CI 0.24–0.67; P = 0.000) were lower and the resection margin was wider (SMD 0.2; 95% CI 0.03–0.37; P = 0.019) in the AL group than in the PS group, no significant differences in blood loss (SMD −0.29; 95% CI −0.68 to 0.09; P = 0.131), complication rate (OR 0.73; 95% CI 0.50–1.07; P = 0.103), hospital stay (SMD −0.53; 95% CI −1.16 to 0.11; P = 0.105), and tumor recurrence (OR 1.23; 95% CI 0.81–1.86; P = 0.334) were noted between the groups. Conclusion: LLR is technically feasible and safe for selected patients with lesions in the PS segments of the liver.