ArticleFrontiers in oncology2025
Comparison of perioperative outcomes of open (CUSA) versus laparoscopic (LOTUS) major hepatectomy - revisited. First evaluation of efficacy and safety of AEON™ stapler.
Article in Frontiers in oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Evaluation of the AEON Powered Stapler System in Primary Sleeve Gastrectomy: Results of a Prospective Clinical Trial.Journal of metabolic and bariatric surgery · 2026Article
- The validity of the AEON™ stapler in gastrointestinal surgery: early clinical experience and translational rationale.Frontiers in oncology · 2026Review
Corrections and comments
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Introduction: In 2019, preliminary data matching 20 laparoscopic (using LOTUS) with 20 open (using CUSA) cases demonstrated the feasibility and improved outcomes of laparoscopic major liver resections using the LOTUS™ liver blade. This updated study presents a larger comparison between open and laparoscopic major hepatectomies and, for the first time, evaluates the safety of the endovascular stapler AEON™ (Lexington Medical, Massachusetts, USA). Methods: All consecutive patients who underwent liver resections, both open and laparoscopic, from January 2020 to June 2023 were identified from a prospectively maintained database. Propensity score matching was performed to identify matched open and laparoscopic cases, which were compared for intra- and post-operative short-term outcomes. The LOTUS™ ultrasonic energy device was used for transection in laparoscopic cases, whereas CUSA was used in open procedures. AEON was introduced in 2021 and compared with the previously used stapler. Results: The initial sample of 116 patients was narrowed to 86 after applying 1:1 matching. The median age was 63 years (range 27-83). Laparoscopic cases showed reduced hospital stay (mean 7.8 vs. 14.7 days; p = 0.025), increased Pringle time (48.5 vs. 33 minutes; p = 0.010), and reduced transfusion requirements (0 vs. 4 units; p = 0.035). Comparing AEON™ with Endo-GIA showed no statistical differences, though AEON™ showed a possible trend toward reduced transection time overall (56 vs. 69 minutes; p = 0.300) and in laparoscopic cases (56 vs. 71 minutes; p = 0.295). Conclusion: The LOTUS™ liver blade continues to demonstrate safety and efficacy in laparoscopic liver resections. Transection time has improved compared to the earlier study, likely reflecting increased experience. AEON™ is shown to be non-inferior for vessel ligation, with a potential trend toward reduced transection time in both open and laparoscopic cases.
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