Role of laparoscopic surgery in the management of gallbladder cancer: Systematic review & meta-analysis
This meta-analysis evaluates the safety and short-term oncological outcomes of laparoscopic vs. open surgery for gallbladder carcinoma(GBC). Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined wit...
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| Veröffentlicht in: | The American journal of surgery 2023-06, Vol.225 (6), p.975-987 |
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| creator | Ahmed, Syeda Hoorulain Usmani, Shajie Ur Rehman Mushtaq, Rabeea Samad, Saba Abid, Minaam Moeed, Abdul Atif, Abdul Raafe Farhan, Syed Ali Saif, Areeba |
| description | This meta-analysis evaluates the safety and short-term oncological outcomes of laparoscopic vs. open surgery for gallbladder carcinoma(GBC).
Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's method to estimate hazard ratios(HRs) and 95% CIs.
There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR: 0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD: 0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65), greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49) favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.
Laparoscopic surgery is non-inferior to the open approach in terms of oncological outcomes and has an improved rate of postoperative complications.
•Gallbladder carcinoma (GBC) is considered a highly lethal disease.•Laparoscopic surgery is non-inferior to open approach oncological outcomes.•Laparoscopic surgery is associated with fewer postoperative complications.•Laparoscopic surgery is comparable to open surgery in terms of overall survival. |
| doi_str_mv | 10.1016/j.amjsurg.2023.01.008 |
| format | Article |
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Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's method to estimate hazard ratios(HRs) and 95% CIs.
There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR: 0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD: 0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65), greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49) favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.
Laparoscopic surgery is non-inferior to the open approach in terms of oncological outcomes and has an improved rate of postoperative complications.
•Gallbladder carcinoma (GBC) is considered a highly lethal disease.•Laparoscopic surgery is non-inferior to open approach oncological outcomes.•Laparoscopic surgery is associated with fewer postoperative complications.•Laparoscopic surgery is comparable to open surgery in terms of overall survival.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2023.01.008</identifier><identifier>PMID: 36693774</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Loss, Surgical ; Blood transfusion ; Cancer ; Chemotherapy ; Cholecystectomy ; Cohort analysis ; Comparative studies ; Complications ; Confidence intervals ; Disease-Free Survival ; Gallbladder ; Gallbladder cancer ; Gallbladder neoplasms ; Gallbladder Neoplasms - surgery ; Humans ; Laparoscopic surgery ; Laparoscopy ; Laparoscopy - methods ; Lymph nodes ; Meta-analysis ; Mortality ; Postoperative ; Postoperative Complications - epidemiology ; Recovery time ; Subgroups ; Surgery ; Survival ; Systematic review ; Treatment Outcome</subject><ispartof>The American journal of surgery, 2023-06, Vol.225 (6), p.975-987</ispartof><rights>2023 Elsevier Inc.</rights><rights>Copyright © 2023 Elsevier Inc. All rights reserved.</rights><rights>2023. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-d7830ee5b3e8195def96375d4b0fa99f1f5c4777ae9a4d11377b5d83e354c5933</citedby><cites>FETCH-LOGICAL-c393t-d7830ee5b3e8195def96375d4b0fa99f1f5c4777ae9a4d11377b5d83e354c5933</cites><orcidid>0000-0002-8234-2586</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2819645418?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36693774$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ahmed, Syeda Hoorulain</creatorcontrib><creatorcontrib>Usmani, Shajie Ur Rehman</creatorcontrib><creatorcontrib>Mushtaq, Rabeea</creatorcontrib><creatorcontrib>Samad, Saba</creatorcontrib><creatorcontrib>Abid, Minaam</creatorcontrib><creatorcontrib>Moeed, Abdul</creatorcontrib><creatorcontrib>Atif, Abdul Raafe</creatorcontrib><creatorcontrib>Farhan, Syed Ali</creatorcontrib><creatorcontrib>Saif, Areeba</creatorcontrib><title>Role of laparoscopic surgery in the management of gallbladder cancer: Systematic review & meta-analysis</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>This meta-analysis evaluates the safety and short-term oncological outcomes of laparoscopic vs. open surgery for gallbladder carcinoma(GBC).
Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's method to estimate hazard ratios(HRs) and 95% CIs.
There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR: 0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD: 0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65), greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49) favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.
Laparoscopic surgery is non-inferior to the open approach in terms of oncological outcomes and has an improved rate of postoperative complications.
•Gallbladder carcinoma (GBC) is considered a highly lethal disease.•Laparoscopic surgery is non-inferior to open approach oncological outcomes.•Laparoscopic surgery is associated with fewer postoperative complications.•Laparoscopic surgery is comparable to open surgery in terms of overall survival.</description><subject>Blood Loss, Surgical</subject><subject>Blood transfusion</subject><subject>Cancer</subject><subject>Chemotherapy</subject><subject>Cholecystectomy</subject><subject>Cohort analysis</subject><subject>Comparative studies</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Disease-Free Survival</subject><subject>Gallbladder</subject><subject>Gallbladder cancer</subject><subject>Gallbladder neoplasms</subject><subject>Gallbladder Neoplasms - surgery</subject><subject>Humans</subject><subject>Laparoscopic surgery</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Lymph nodes</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Postoperative</subject><subject>Postoperative Complications - epidemiology</subject><subject>Recovery time</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Survival</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkUtr3DAUhUVpaCbT_oQGQSFkY1caWZaVTQghLxgo9LEWsnQ9kZHtiWQn-N9Xw0yyyCari-A7516dg9B3SnJKaPmzzXXXxils8hVZsZzQnJDqE1rQSsiMVhX7jBaEkFUmS0qO0UmMbXpSWrAv6JiVpWRCFAu0-T14wEODvd7qMEQzbJ3BO18IM3Y9Hh8Bd7rXG-igH3fkRntfe20tBGx0byBc4D9zHKHTY9IGeHbwgs9wB6POktLP0cWv6KjRPsK3w1yif7c3f6_vs_Wvu4frq3VmmGRjZkXFCACvGVRUcguNLJngtqhJo6VsaMNNIYTQIHVhKU2fqLmtGDBeGC4ZW6Lzve82DE8TxFF1LhrwXvcwTFGtRCm5JIyJhP54h7bDFNK9iUrLy4IXtEoU31MmpRMDNGobXKfDrChRuyZUqw5NqF0TilCVmki604P7VHdg31Sv0Sfgcg9AiiNFFlQ0DlKc1gUwo7KD-2DFf-63nMY</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Ahmed, Syeda Hoorulain</creator><creator>Usmani, Shajie Ur Rehman</creator><creator>Mushtaq, Rabeea</creator><creator>Samad, Saba</creator><creator>Abid, Minaam</creator><creator>Moeed, Abdul</creator><creator>Atif, Abdul Raafe</creator><creator>Farhan, Syed Ali</creator><creator>Saif, Areeba</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8234-2586</orcidid></search><sort><creationdate>202306</creationdate><title>Role of laparoscopic surgery in the management of gallbladder cancer: Systematic review & meta-analysis</title><author>Ahmed, Syeda Hoorulain ; 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Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's method to estimate hazard ratios(HRs) and 95% CIs.
There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR: 0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD: 0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65), greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49) favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.
Laparoscopic surgery is non-inferior to the open approach in terms of oncological outcomes and has an improved rate of postoperative complications.
•Gallbladder carcinoma (GBC) is considered a highly lethal disease.•Laparoscopic surgery is non-inferior to open approach oncological outcomes.•Laparoscopic surgery is associated with fewer postoperative complications.•Laparoscopic surgery is comparable to open surgery in terms of overall survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36693774</pmid><doi>10.1016/j.amjsurg.2023.01.008</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-8234-2586</orcidid></addata></record> |
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| subjects | Blood Loss, Surgical Blood transfusion Cancer Chemotherapy Cholecystectomy Cohort analysis Comparative studies Complications Confidence intervals Disease-Free Survival Gallbladder Gallbladder cancer Gallbladder neoplasms Gallbladder Neoplasms - surgery Humans Laparoscopic surgery Laparoscopy Laparoscopy - methods Lymph nodes Meta-analysis Mortality Postoperative Postoperative Complications - epidemiology Recovery time Subgroups Surgery Survival Systematic review Treatment Outcome |
| title | Role of laparoscopic surgery in the management of gallbladder cancer: Systematic review & meta-analysis |
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