Evidence map›Paper›PMID 41313746›Full record

ArticleBJS open2025

Laparoscopic versus open liver resection in patients aged at least 80 years: retrospective propensity score-matched cohort study.

Concepción Gómez-Gavara, Zenichi Morise, Victor López-López, Christoph Kuemmerli, Daniel Esono, Kazuharu Igarashi, Kohei Mishima, Akishige Kanazawa, Shogo Tanaka, Shoji Kubo and 49 more

Abstract readComparative StudyMulticenter Study
In one paragraph

Article in BJS open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

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59 authors.

Concepción Gómez-GavaraHepatopancreatobiliary and Transplantation Surgery Service, Vall d'Hebron University Hospital, Barcelona, Spain.ORCID 0000-0001-8312-3273
Zenichi MoriseDepartment of Surgery, Fujita Health University School of Medicine Okazaki Medical Center, Okazaki, Aichi, Japan.ORCID 0000-0001-6382-6502
Victor López-LópezDepartment of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Spain.ORCID 0000-0003-1718-3352
Christoph KuemmerliDepartment of Surgery, Clarunis University Center for Gastrointestinal and Liver Disease, St Clara Hospital and University Hospital, Basel, Switzerland.
Daniel EsonoDepartment of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, Spain.
Kazuharu IgarashiDepartment of Surgery, Ageo Central General Hospital, Ageo, Japan.
Kohei MishimaDepartment of Surgery, Ageo Central General Hospital, Ageo, Japan.
Akishige KanazawaDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan.
Shogo TanakaDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Shoji KuboDepartment of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Satoshi NemotoDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Goro HondaDepartment of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
Kazuteru MondenDepartment of Surgery, Fukuyama City Hospital, Fukuyama, Japan.
Masaki UenoDepartment of Surgery, Wakayama Medical University, Wakayama, Japan.ORCID 0000-0001-6310-0795
Yasuhito IwaoDepartment of Surgery, Ohta-Nishinouchi Hospital, Kōriyama, Japan.
Naoto GotohdaDepartment of Surgery, National Cancer Center Hospital East, Chiba, Japan.
Masashi KudoDepartment of Surgery, National Cancer Center Hospital East, Chiba, Japan.
Hiroyuki NittaDepartment of Surgery, Iwate Medical University, Iwate, Japan.
Satoshi AmanoDepartment of Surgery, Iwate Medical University, Iwate, Japan.
Rafael Díaz-NietoDepartment of Surgery, Liverpool University Hospital, Liverpool, UK.
Alex Gordon-WeeksDepartment of Surgery, Liverpool University Hospital, Liverpool, UK.ORCID 0000-0003-2997-4194
Serena LangellaS Chirurgia Generale e Oncologica, Ospedale Mauriziano, Turín, Italy.
Alessandro FerreroS Chirurgia Generale e Oncologica, Ospedale Mauriziano, Turín, Italy.
Yuichiro OtsukaDepartment of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
Hironori KanekoDepartment of Surgery, Toho University Faculty of Medicine, Tokyo, Japan.
Riccardo BoettoDepartment of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation Unit, Padova University Hospital, Padova, Italy.
Umberto CilloDepartment of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation Unit, Padova University Hospital, Padova, Italy.ORCID 0000-0002-2310-0245
Daniel D'SouzaDepartment of Surgery McMaster University, Hamilton, Ontario, Canada.
Pablo E SerranoDepartment of Surgery McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-3715-6880
Giammauro BerardiAzienda Ospedaliera San Camillo Forlanini, General Surgery and Transplant Unit, Rome, Italy.ORCID 0000-0001-8827-9189
Marco AngrisaniAzienda Ospedaliera San Camillo Forlanini, General Surgery and Transplant Unit, Rome, Italy.ORCID 0000-0001-6414-7835
Giuseppe Maria EttorreAzienda Ospedaliera San Camillo Forlanini, General Surgery and Transplant Unit, Rome, Italy.
Parissa TabrizianMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Allen YuMount Sinai Liver Cancer Program, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Brian K P GohDepartment of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre, Singapore, Singapore.
Takuya MinagawaDepartment of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.
Osamu ItanoDepartment of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan.ORCID 0000-0002-2197-9508
Daisuke AsanoDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Minoru TanabeDepartment of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
Marcello Di MartinoHepatopancreatobiliary Unit, Department of General and Digestive Surgery, Hospital Universitario La Princesa, Instituto deInvestigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.ORCID 0000-0001-6510-7210
Elena Martín-PérezHepatopancreatobiliary Unit, Department of General and Digestive Surgery, Hospital Universitario La Princesa, Instituto deInvestigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid (UAM), Madrid, Spain.
Simone FamularoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.ORCID 0000-0002-9721-6304
Elisa Paoluzzi TomadaDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Guido TorzilliDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.ORCID 0000-0001-5798-5021
Jaime Arthur Pirola KrügerDepartment of Gastroenterology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.
Paulo HermanDepartment of Gastroenterology, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, Brazil.
Mario GiuffridaGeneral Surgery Unit, Parma University Hospital, Parma, Italy.ORCID 0000-0001-8335-3941
Ramon CharcoHepatopancreatobiliary and Transplantation Surgery Service, Vall d'Hebron University Hospital, Barcelona, Spain.
Mikel GastacaHepatobiliary Surgery and Liver Transplant Unit, Cruces University Hospital BioCruces Health Research Institute, Vizcaya, Spain.
Waclaw HolowkoDepartment of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.ORCID 0000-0003-1419-2704
Stephanie TruantDepartment of Digestive Surgery and Liver Transplantation, University Hospital C. Huriez, Lille, France.
Kit-Man HoDepartment of Surgery, Kwong Wah Hospital, Hong Kong, China.
Kai-Chi ChengDepartment of Surgery, Kwong Wah Hospital, Hong Kong, China.ORCID 0000-0002-6440-7825
Rafael José MauretteGeneral Surgery Department, British Hospital of Buenos Aires, Buenos Aires, Argentina.
Laura-Ann BlattDepartment of General, Visceral and Thoracic Surgery, Surgical Oncology, Klinikum Saarbruecken, Saarbruecken, Germany.
Tatiana BeldaDepartment of Surgery, Verge dels Lliris Hospital, Alcoy, Spain.
Yuta AbeDepartment of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan.
Shuichiro UemuraDepartment of Surgery, Keio University School of Medicine, Keio University Hospital, Tokyo, Japan.
Go WakabayashiDepartment of Surgery, Ageo Central General Hospital, Ageo, Japan.

Funding

Howard Hughes Medical InstituteNIH HHSWellcome Trust
6 · The paper itself

Abstract

backgroundLaparoscopic liver resection has been associated with less morbidity than, and similar global outcomes to, open liver resection. There is no robust evidence that these outcomes lead to similar clinical outcomes in patients aged over 80 years. The aim of this study was to analyse the short-term outcomes between open and laparoscopic liver resection in patients over 80 years old.

methodsA retrospective analysis was undertaken. The study population comprised patients aged ≥ 80 years who underwent laparoscopic or open liver resection between January 2014 and December 2019, and who presented with resectable malignant tumours. The primary outcome was postoperative morbidity, according to Dindo-Clavien grading. Cox regression models were used to compute hazard ratios and 95% confidence intervals. Propensity score matching (1 : 1) was performed to balance the two groups according to independent prognostic factors for morbidity.

resultsA total of 988 patients were analysed from 34 centres (16 from Asia, 14 from Europe and 4 from America): 487 in the open group and 501 in the laparoscopic group. Independent risk factors associated with severe morbidity were the open approach (hazard ratio 1.59, 95% confidence interval 1.19 to 2.11; P < 0.001), Charlson Co-morbidity Index score > 7 (HR 1.69, 1.26 to 2.27; P < 0.001), more than one resected tumour (hazard ratio 1.55, 1.13 to 2.11; P = 0.006), major hepatectomy (hazard ratio 1.86, 1.22 to 2.83; P = 0.003), and Iwate score ≥ 7 (hazard ratio 1.43, 1.02 to 2.01; P = 0.03). Before propensity score matching, severe morbidity, length of intensive care unit stay, 90-day mortality, length of hospital stay, and readmission were better in the laparoscopic group (P < 0.050). These observations were confirmed after propensity score matching.

conclusionThe laparoscopic approach is a safe procedure for elderly patients, with better morbidity and mortality outcomes than the open approach, and should be considered as a default option.

Indexed as

HepatectomyLaparoscopyLiver NeoplasmsPostoperative ComplicationsAged, 80 and overFemaleHumansLength of StayMalePropensity ScoreRetrospective StudiesRisk FactorsTreatment Outcomecomplicationsgeriatric populationIwate scorematching scoreminimally invasive surgeryolder adults

Identifiers

PMID41313746
PMCPMC12662231

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.