14 series showed equivalent resection margins between open and lap resections 4 series showed significantly better resection margins in lap vs open resections 1 series showed significantly worse resection margins in lap vs open resections LAPAROSCOPIC MINOR-ONLY RESULTS RESECTIONS Author Year N Type of lesion Mortality Conversion rate Complications Blood loss transfusion Operation time Hospital Stay Bile leak Resection margins Comments LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR -mm -posit -<1cm OLR -mm -posit -<1cm COMPARATIVE STUDIES Memeo(1) Creteil-France 2014 45 15biS 11S 17subS 45 15biS 11S 17subS HCC 0 2(4,5%) 0 9(20%) 20(45%) 200 200 0 (0-4) 0 (0-10) 140 180 7(0-69) 12 0 0 -5% -/ -6(0-58) -15% -/ Well matched P=0,15 P=0,01 P=0,11 P=0,18 P=0,02 P<0,0001 -P=0,02 -P=0,03 -/ Chan(2) Hong Kong-China 2014 17 9LLS 1S 7subS 34 2S 16subS Malign 0 0 5,8% 4(23,5%) 12(35,2%) 150 330 2(11,8%) 2(6,1%) 6(3-15) 8(5-105) 0 0 10(0-20) Population: Elderly patients > 70 Potential duplication in Ref. 8. Excluded 29 cases in the lap(12) and open(17) groups in final count P=0,046 P=0,878 P=0,436 P=0,005 P=0,791
Montreal-Canada 44LLS 29LLS Malign + Benign Included in Rao et al. 2012 P=0,001 P=0,28 P=0,08 P=0,001 Carswell(17) London-UK 2009 10 10LLS 10 10LLS Malign + Benign 0 0 1(10%) 2(20%) 2(20%) - - 10% 20% 6 9 0 0 - 0 - / -14(1-20) - 0 - / Included in Rao et al. 2012 P=0,782 P=0,315 P=0,005 P=0,669 Tsinberg(18) Cleveland-USA 2009 31 8BiS 23S 43 28S Malign + Benign 0 0 0 4(13%) 7(16%) 122.5 ± 45.4 299,6 ± 33,6 - - 201 ± 15 172 ± 12 3.2 ± 1 6.8 ± 0.7 0 0 - 8,2±2 - 2(18%) - / - 8,5±1,3 - 1(3%) - / Included in Rao et al. 2012 Has financial analysis P=0,7 P=0,002 P=0,1 P=0,004 - P=0,9 - / - / Abu Southampton-UK 2008 24 24LLS 20 20LLS Malign + Benign 0 0 0 13% 25% 80 470 - - 180 155 3,5 (1-6) 7 (3-12) 0 0 -12(4-40) Included in Rao et al. 2012. Duplicated in Ref. 6. All cases excluded form the count P=0,541 P=0,002 P=0,885 P<0,001 P=1 Aldrighetti(20) Milan-Italy 2008 20 20LLS 20 20LLS Malign + Benign 0 0 0 2(10%) 5(25%) 165 ± 43 214 ± 47 0 0 260±50 220±30 4.5 ± 0.6 5.8 ± 1.6 0 0 -11±3 -13±5 Well-matched cohorts Included in Rao et al. 2012 Duplicated paper in Ref 12. Excluded 16 cases from open(8) and lap(8) P=NS P=0,001 P=NS P=0,003 P=NS
- 5 - 5 Parks et al. 2014 P=NS P=NS P=NS P=NS P<0,001 P=0,57 Shimada(32) Fukuoka-Japan 2001 17 7LLS 10subS 38 HCC 0 0 0 1(5,9%) 4(10,5%) 400 (188, 1050) 800 (500, 1125) 5,9% 10,5% 325 (214, 430) 280 (215, 318) 12 ± 5 22 ± 8 0 0 - 8±7 - / - 41,2% - 7±6 - / - 50% Well-matched Included in Xiong et al. 2012, Yin et al 2013 and Parks et al. 2014 P=0,99 P=0,08 P=0,99 P=0,18 P<0,001 P=0,65 P=0,54 CLINICAL SERIES Long(33) Ho Chi 2014 173 - HCC 0 0 4(2,3%) 4(2,4%) - 100 - - 112 ± 56 . 6.5 ± 2.0 - 2(1,2%) - Hwang(34) Multic-Korea 2013 744 - Malign + Benign 2(0,27%) - 34(4,6%) 52(7%) - 410.0 ± 451.4 - 67(9%) - 214.9 ± 114.1 - 8.6 ± 5.0 - - - Zhen(35) Guang 2010 29 3S 17BiS 9LLS - HCC 0 - 3(10,3%) 9(31,03%) - 164 - 0 - 120 - 7,08 - 0 - Lai(36) Hong Kong-China 2010 19 19LLS - 2010 9 - Malign Hand-assisted Santambrogio(38) Milan-Italy 2009 22 5BiS 9S - HCC 0 - 13,6% 2(9%) - 18372 - 1(4,5%) - - 5,41 - 0 - Vietnam China
3nAR Vigano(39) Creteil-France 2009 60 60LLS - Malign + Benign 0 - A. 1(5%) B. 0 A. 1(5%) A.4(20%) B.1(5%) 0 - A.200 B.200 C.100 - A.0 B.0 C1(5%) - A.180 B.170 C.140 - A.7 B.5 C.5 - 0 - A. first 20 B. second 20 C. last 20 Sasaki(40) Morioka-Japan 2009 82 71w 11LLS - Malign + Benign 0 - 1(1,2%) 3(4%) - 64 - 4(4,8%) - 177 - 9 (3-37) - 1(1,2%) - Chen(41) 2008 97 - HCC 0 - 0 6,2% - 101.6 ± 324.4 - 5(5,1%) - 152.4 ± 336.3 - - 0 - Pai(42) London-UK 2008 28 - Malign + Benign Nissen(43) Los Angeles-USA 2007 15 15nAn - Malign + Benign 0 - 1(7%) to HA 2(13,3%) . - - 0 - - - 4,1(1-5) - 0 - Chang(44) Creteil-France 2007 36 36LLS - Malign + Benign 0 - 1 (2,7%) 2(5,5%) - 208 - 0 - 171,5 (90–240) - 7,8 - 0 - Duplicated paper on Ref. 39. All cases excluded from the final count Poultsides(45) Hartford-USA 2007 28 - Malign + Benign Hand-assisted Bachelier(46) London-UK 2007 18 - Malign + Benign Toyama(47) Chiba-Japan 2006 9 - Malign 0 - 0 2(22,2%) - 77.4 37.2 - 0 - 113.6 41.3 - 11.3 3.9 - 0 - 3-ports lap resections
Naples-Italy 2006 8 8LLS - Malign + Benign 0 - 0 0 - 170 - 0 - 142 - 5,7 - 0 - Kamiyama(49) Sapporo-Japan 2005 8 7LLS 1nAR - HCC 0 - 0 2(25%) - 177.6 129.1 - - - 181.1 44.6 - 9.88 4.36 - 0 - Croce(50) Monza-Italy 2003 7 - Malign + Benign 0 - 0 0 - 120 - 0 - 90 - 4 - 0 - Huang(51) Taipei-Taiwan 2003 7 Malign + Benign Hand-assisted Teramoto(52) Tokyo-Japan 2003 11 HCC CN Tang(53) Hong Kong-China 2003 6 6LLS Benign Hand-assisted Duplicated paper in Ref. 36. All cases excluded from the final count Cherqui(54) Creteil-France 2002 2 2LLS LDLT Antonetti(55) Hartford-USA 2002 11 - Malign + Benign 0 - 0 2(18%) - 150 - 0 - 197±62 - 4,5 - 0 - Hand-assisted Duplicated paper in Ref. 45. All cases excluded from the final count Ker(56) 2000 9 9subS - HCC 0 - 0 1(11%) - - - 0 - - - 4-7 - 0 - Duplicated paper on Ref. 41. All cases excluded from
the final count Fong(57) New York-USA 2000 11 - Malign 0 - 6(54%) 2/5 - - - - - 248 - 5 - 1(20%) . Hand-assisted Data of 5 patients Katkhouda(58) Los Angeles-USA 1999 43 - Benign 0 - 3(7%) 6(14,1%) - 156 - 3(7%) - 179 - - 0 - Samama(59) Caen-France 1998 4 4LLS Malign + Benign Azagra(60) 1996 1 1LLS Benign 0 - 0 0 - LAPAROSCOPIC MINOR/MAJOR COMBINED-RESULTS RESECTIONS Author Year N Type of lesion Mortality Convers. rate Complications Blood loss transfusion Operation time Hospital Stay Bile leak Resection margins Comments LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR -mm -<1cm OLR -mm -posit -<1cm COMPARATIVE STUDIES Franken(61) Los Angeles-USA 2014 52 7maj 45min 52 7maj 45min Malign + Benign 1(2%) 2(4%) 7(13%) 22(42%) 19(37%) 237(10-1200) 1(2%) 5(10%) 219 (84-449) 198 5(1-17) 6(3-23) 0 2(4%) - / - 2(4%) - / - / - 1(2%) - /
Ghent-Belgium 1maj 19min 2maj 18min P=0,176 P=0,673 P=0,008 P=NS Cai(99) Hangzhou-China 2007 29 26min 3maj 22 2maj Benign 0 0 1(3,3%) 2(6,8%) 4(18,2%) 603 ± 525 655 ± 569 - - 236 ± 135 220 ± 61 8.8 ± 4.4 13 ± 9.2 1(3,4%) 1(3,4%) - - P=0,424 P=0,737 P=0,589 P=0,045 Koffron(100) Illinois-USA 2007 241 175min 100 49min 51maj Malign + Benign 0 0 20(6%) to H-assisted 9,3% 22% 100 325 0 8% 95 182 1,7 5,4 2(0,8%) 4(4%) - - No P values as no comparisons Included in Rao et al. 2012 Ohio-USA 2004 17 5maj 16min 100 ¿ Malign + Benign 1(5,8%) - - 4(23%) - 288(50-150) 485 - - 2,8 4,5 2,9 (1-14) 6,5 1(5,8%) - - - Included in Rao et al. 2012 P<0,05 P<0,05 P<0,05 CLINICAL SERIES Shelat (102) Southampton-UK 2014 19 2maj - Malign + Benign 0 - 0 1(5,2%) - 100 (50-275) - - - 165 (90-203) - 4(1-8) - 0 - -/ -1(5,2%) -/ - Primary resection Potential duplication in Ref. 153. 2 major resections excluded from analysis Shelat (102) Southampton-UK 2014 20 6maj - Malign + Benign 0 - 3 (15%) 2(10%) - 400 - - - 285 - 4(1-57) - 1(5%) - -/ -2(10%) -/ - Repeat lap liver resection on same population as before Potential duplication in Ref. 153. 6 major resections excluded from analysis
Shelat(103) Southampton-UK 2014 52 32maj 20min - Malign 0 - 8(15,4%) 6(11,5%) - 500 - - - 240 - 5(1-21) - 1(1,9%) - -/ -4(7,7%) -/ - Large tumors only. Mean tumor diameter = 83 mm (range 50-180) Potential duplication in Ref. 153. 32 major resections excluded from analysis Honda(104) Tokyo-Japan 2014 29 - Malign 0 - 1(3,4%) 20,7% - 141 (5-430) - - - 329 - 9(4-21) - 1(3,4%) - -/ -1 -/ Cannon(105) Louisville-USA 2014 52 47min 5maj - Malign + Benign 5(9,6%) - - 13(25%) - 100 (50-1500) - 8(15,4%) - 120 (60-360) - 3(0-16) - - - Only cirrhotic patients Soyama(106) Nagasaki-Japan 2014 102 62maj 40min - Malign + Benign Hand-assisted Cai(107) Hangzhou-China 2014 365 80LH 112LLS 68nAR 35S 11;Oth - Malign + Benign 0 - 63(17,2%) 12,24% - 370.6±404.0 - - - 150.8±73.0 - 9.2 ± 5.3 - 1,32% - Laparoscopic Peng’s multifunction operative disector (LPMOD) Troisi(108) Ghent-Belgium 2014 265 46maj 219min - Malign + Benign 0 . 17(6,4%) 38(11,3%) - 172±150 - - - 254±111 - 5,5±3,6 - 4(1,5%) -
Soubrane(109) Paris-France 2014 351 36maj 315min - HCC 7(2%) - 45(13%) 80(23%) - - - 12(3%) - 180 (15-655) - 7(1-90) - 7(2%) - Potential duplication with papers 119, 39, 138, 140, 142. All cases excluded from final count Choi(110) Gwangju-Korea 2013 57 14maj - HCC Tokyo-Japan 2013 41 7maj - Malign 0 - 2(4,9%) 9,8% - 216 (0-1600) - 0 - 361 8 (5-28) - 0 - Only Ikeda(112) Fukuoka-Japan 2013 30 7RH 4RPS - Malign 0 - 0 2(6,6%) - 91 (0–330) - 1(3,3%) - 301 (79–697) - 9 (5-15) - 0 - Semiprone position Casaccia(113) Genoa-Italy 2012 22 1maj 21min - HCC Park(114) Multic-Korea 2012 416 105maj 311min - Malign + Benign 2001-2008 Gumbs(115) Philapdelphia-USA 2012 53 28min 25maj - Malign + Benign Costi(116) 2012 100 52maj 48min - Malign + Benign + LDLT 0 - 17% 29% - 120±127.6 - 1% - 253±91.6 - 8.9 ± 9 - 4% - 39 LLS LDLT included as major
135min cases excluded from final count Zhang(124) 2009 78 7maj 71min - Malign + Benign 0 - 0 0 - 288 - 4 (5,12%) . 165 (60-390) - 5,6 (2-10) - 0 - Vigano(39) Creteil-France 2009 174 - Malign + Benign 0 - A. 9(15,5%) B. 6(10,3%) C. 2(3,4%) A.17,2% B.22,4% C.3,4% - A. 300 B. 200 C. 200 - A. 6,9% B. 5,2% C. 3,4% - A. 210 B. 180 C. 150 - A. 7 B. 7 C. 6 - A. 0 B. 1 C. 1 - A. first 58 B. second 58 C. last 58 Nguyen(125) Pittsburgh-USA 2009 109 37S 31RH 10LH 1ERH 1Caud - CRLM 0 - 4(3,6%) 13(11,9%) - 200 (20-2500) - 11(10,1%) - 234 (60-555) - 4(1-22) - 3(2,75%) - Otsuka(126) Tokyo-Japan 2009 90 - Malign + Benign 0 - 2(2,2%) 11(12,2%) - 262.9 ± 344.8 - - - 268.0 ± 123.1 - 11.8 ± 7.3 - 1(1,1%) - Machado(127) Sao Paulo-Brasil 2009 9 8min 1maj - Malign + Benign 0 - 0 0 - - - 1(11%) - 180 - 3 (1-5) - 0 - All left liver resections Inagaki(128) 2009 68 4 maj 64min - Malign + Benign 0 - 2(2,9%) 18(26,4%) - 393 ± 564 - - - 214 ± 93 - 15,12 - 1(1,4%) - 2009 45 - Malign + Benign
Taipei-Taiwan 3maj 42min Itano(130) Tokyo-Japan 2009 19 ¿ - Malign + Benign Cho(131) Gyeonggi-do-Korea 2008 128 47maj 81min - Malign + Benign Machado(132) Sao 2008 7 3min 4maj - Malign Abouljoud(133) Detroit-USA 2008 11 7maj 4min - Benign Alkari(134) Manchester-UK 2008 24 20 min 4maj - Malign + Benign 0 - 0 4% - 100 (25-1100) - 1(4,1%) - 155(50-300) - 3(1-14) - - - Cho(135) Seoul-Korea 2008 82 26maj 56min - Malign + Benign 0 - 4(5%) 12(15%) . 425 (20-900) - 21 (26%) - 240 (30-540) - 9(4-21) - 1(1,2%) - Buell(136) Louisville-USA 2008 253 70maj 183min - Malign + Benign 4(1,6%) - 6(2,4%) 41(16%) - 222 - 7% - 162 - 2,9 - 4% - Chen(41) Kaohsiung-Taiwan 2008 19 - HCC 0 - 0 1(5,2%) - 329.2 ± 338.0 - 3(15,7%) - 175.8 ± 57.4 - 6,4 - 0 -
Gigot(143) Brussels-Belgium 2002 37 2maj 35min - Malign 10HCC 27CRLM 0 - 13,5% 8(22%) - - - 6(16%) - - - 7(2-16) - 0 - Cherqui(144) Creteil-France 2000 30 1maj 29min - Malign + Benign 0 - 2(6,6%) 6(20%) - 300(0-1500) - 10% - 214 ± 87 - 9,6(3-40) - 0 - Duplicated in Ref. 39. All cases excluded from final count. Hüscher(145) Esine-Italy 1997 20 14maj 6min - Malign 1(5%) - 0 45% - 397,5 - 7(35%) - 193 - 11(5-25) - 1(5%) - LAPAROSCOPIC MAJOR-ONLY RESECTIONS Author Year N Type of lesion Mortality Convers. rate Complications Blood loss Blood transfusion Operation time Hospital Stay Bile leak Resection margins Comments LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR OLR LLR -mm -posit -<1cm OLR -mm -<1cm COMPARATIVE STUDIES Medbery(146) Atlanta-USA 2014 46 46RH 57 57RH Malign + Benign 2(4,2%) 2(3,5%) 5(10,4%) 13(27,1%) 25(43,9%) 281±306 737±947 - - 233±32 285±85 5(3-31) 7(4-35) -/ -/ -/ -4(7%) -/
France+Italy 2008 6 4RH 2LH 6 4RH 2LH Benign 0 0 0 1(16,6%) 0 205 ± 156.7 341.7 ± 28.1 - - 201.7 ± 64.01 180.0 ± 38.9 5.5 ± 1 10.8 ± 2.6 1(16,6%) 0 - - P=0,129 P=0,4 P=0,001 Di Fabio(153) 2014 127 - Malign + Benign 2(1,6%) - 11(9%) 28(22%) . 500 - - - 330 - 5(4-7) - 3(2,3%) - -/ -/ - Some cases may be potentially duplicated in Ref. 154, but impossible to know. CLINICAL SERIES Hwang(34) Multic-Korea 2013 265 - Malign + Benign 2(0,75%) - 17(6,4%) 53(20%) - 836.0 ± 1223.7 - 65 (24,5%) - 399.3 ± 169.8 - 12.3 ± 7.9 - - - Nitta(154) 2013 106 - - - - 8 full-lap 4 84 No convers. 18(17%) - - - - - - - - - 6(5,6%) - Tzanis(155) Multic-Europe 2013 495 348RH 108LH 5CH 34Tri - Malign + Benign - - 49(10,8%) - - 437-RH 275-LH - - - 301-RH 250-LH - - - - - Pearce(156) 2011 35 35RH - Malign + Benign 0 - 7(19,6%) 4 (11,4%) - 650 - - - 295 - 5 - 1(2,8%) - Duplication in Ref. 155. All cases excluded from final count Pearce(157) 2011 20 20LH - Malign + Benign Duplication in Ref. 155. All cases excluded from final count
2010 42 2RTri 14RH 16LH 10Oth - Malign + Benign 0 - - 5(11,9%) - 631 6(14,2%) 317 - 13 - 2(4,8%) - LAP-ASSISTED + HANGING Dagher(159) 2009 210 136RH 74LH - Malign + Benign 2(0,9%) - 26(12,4%) 46(21,9%) - - 30(14,3%) - 250±103,8 - 6±4,5 - 13(6,2%) - MULTICENTER Cho(160) Seoul-Korea 2007 6 4LH 2RH - Malign + Benign 0 - 0 0 - 370 - 0 - 175 - 9 - 0 - Hand-assisted Duplication in Ref. 34. All excluded from final count DISTRIBUTION BY NUMBERS, HOSPITALS AND COUNTRIES Japan
Hospital of Chinese People's Liberation Army, Beijing, Hépatobiliaire, Hôpital Paris 12, Créteil, France. 2009 2009 2009 2007 2003 2003 2002 2000 166 174 60 36 13 18 2 30 Hospital Transplant Program, Department of Surgery, Hartford Hospital, CT, USA. 2002 11 ASIA Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Shatin, Hong Kong 2011 2007 33 25 EUROPE Department of General and Surgery, S. M. Loreto Nuovo Hospital Via A. Vespucci, 80142 Naples, Italy. 2009 2007 2006 2004 54 23 8 16 USA Division of Transplantation, University of Cincinnati, OH USA. 2004 17 ASIA Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Jeonnam, 519-809, Korea 2011 20 EUROPE AP-HP Hopital Paul Brousse, Centre Hépato-Biliaire, Villejuif F-94804, France. 2009 60 USA Department of Surgery, University of Southern California School of Medicine, Los Angeles USA. 1999 43 ASIA Hepato-bilio-pancreatic Surgery Department, Northern Jiangsu People's Hospital, Yangzhou 225001, Jiangsu Province, China. 2011 30 MULTIC EUROPE / USA / AUSTRALIA Dagher(159) Clamart-France 2009 210 ASIA Division of HBP Surgery, Chung-Ho Memorial Hospital, Institute of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan. 2011 116 EUROPE Unit of HPB and Advanced Laparoscopic Surgery, Department of Surgery and Molecular Oncology, Ninewells Hospital and Medical School, University of Dundee, Dundee, DD1 9SY, UK. 2008 25 ASIA Department of Hepatobiliary Surgery, First People's Hospital of Foshan, Foshan, Guang Dong, China. 2010 29 EUROPE HPB unit, Division of Surgery, Hammersmith Hospital, Imperial College London, Oncology, Reproductive Biology and Anaesthesia, London, UK 2008 2007 28 18 Université