In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 3 ( 2021-3-11), p. e0248534-
Abstract:
Minimally invasive surgery (MIS) provides a new approach for patients with hilar cholangiocarcinoma (HCCA). However, whether it can achieve similar outcomes to traditional open surgery (OS) remains controversial. Methods To assess the safety and feasibility of MIS for HCCA, a systematic review and meta-analysis was performed to compare the outcomes of MIS with OS. Seventeen outcomes were assessed. Results Nine studies involving 382 patients were included. MIS was comparable in blood transfusion rate, R0 resection rate, lymph nodes received, overall morbidity, severe morbidity (Clavien–Dindo classification 〉 = 3), bile leakage rate, wound infection rate, intra-abdominal infection rate, days until oral feeding, 1-year overall survival, 2-year overall survival and postoperative mortality with OS. Although operation time was longer (mean difference (MD) = 93.51, 95% confidence interval (CI) = 64.10 to 122.91, P 〈 0.00001) and hospital cost (MD = 0.68, 95% CI = 0.03 to 1.33, P = 0.04) was higher in MIS, MIS was associated with advantages of minimal invasiveness, that was less blood loss (MD = -81.85, 95% CI = -92.09 to -71.62, P 〈 0.00001), less postoperative pain (MD = -1.21, 95% CI = -1.63 to -0.79, P 〈 0.00001), and shorter hospital stay (MD = -4.22, 95% CI = -5.65 to -2.80, P 〈 0.00001). Conclusions The safety and feasibility of MIS for HCCA is acceptable in selected patients. MIS is a remarkable alternative to OS for providing comparable outcomes associated with a benefit of minimal invasiveness and its application should be considered more.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0248534
DOI:
10.1371/journal.pone.0248534.g001
DOI:
10.1371/journal.pone.0248534.g002
DOI:
10.1371/journal.pone.0248534.g003
DOI:
10.1371/journal.pone.0248534.g004
DOI:
10.1371/journal.pone.0248534.g005
DOI:
10.1371/journal.pone.0248534.g006
DOI:
10.1371/journal.pone.0248534.g007
DOI:
10.1371/journal.pone.0248534.g008
DOI:
10.1371/journal.pone.0248534.g009
DOI:
10.1371/journal.pone.0248534.g010
DOI:
10.1371/journal.pone.0248534.g011
DOI:
10.1371/journal.pone.0248534.g012
DOI:
10.1371/journal.pone.0248534.g013
DOI:
10.1371/journal.pone.0248534.g014
DOI:
10.1371/journal.pone.0248534.g015
DOI:
10.1371/journal.pone.0248534.g016
DOI:
10.1371/journal.pone.0248534.g017
DOI:
10.1371/journal.pone.0248534.g018
DOI:
10.1371/journal.pone.0248534.t001
DOI:
10.1371/journal.pone.0248534.t002
DOI:
10.1371/journal.pone.0248534.s001
DOI:
10.1371/journal.pone.0248534.s002
DOI:
10.1371/journal.pone.0248534.s003
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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