{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:49:30Z","timestamp":1773269370760,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,8,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Laparoscopic major hepatectomy is expanding, but little data exist comparing surgical approaches. The aim of this study was to test the hypothesis that pure laparoscopic liver resection (PLAP) has advantages over hand\u2010assisted (HALS) or hybrid (HYB) resection for major hemi\u2010hepatectomy at two western centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using propensity score matching, 65 cases of HALS\u2009+\u2009HYB (18 hand\u2010assisted and 47 hybrid) were matched to 65 cases of PLAP. Baseline characteristics were well matched for gender, age, ASA score, Childs A cirrhosis, right\/left hepatectomy, malignancy, tumor size, and type between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The HALS\u2009+\u2009HYB group had 27 right and 38 left major hepatectomies (<jats:italic>n\u2009<\/jats:italic>=\u200965) versus 29 right and 36 left (<jats:italic>n\u2009<\/jats:italic>=\u200965) in the PLAP group (<jats:italic>p\u2009<\/jats:italic>=\u2009NS). The median number of lesions resected was 1\u00a0in each group, with median size 5.6\u00a0cm (HALS\u2009+\u2009HYB) versus 6.0\u00a0cm (PLAP), (<jats:italic>p\u2009<\/jats:italic>=\u2009NS). The HALS\u2009+\u2009HYB group had shorter OR time (240 versus 330\u00a0min, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.01), and less blood loss (EBL 150\u00a0ml vs. 300\u00a0ml, <jats:italic>p\u2009<\/jats:italic>&lt;\u20090.01) versus the PLAP group, respectively. Median length of stay (LOS) was 4\u00a0days with HALS\u2009+\u2009HYB versus 5\u00a0days in the PLAP group (<jats:italic>p\u2009<\/jats:italic>=\u20090.02). There were no significant differences in use of the Pringle maneuver, transfusion rate, ICU stay, post\u2010op morbidity, liver\u2010specific complications, or R0 resection. Pain regimen\/usage in each group is provided. There were no 30\/90\u2010day deaths in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first reported series of propensity score matching of HALS\u2009+\u2009HYB versus PLAP for major hepatectomy. The HALS\u2009+\u2009HYB group had non\u2010inferior OR time, blood loss, and LOS versus the PLAP group, while the other perioperative parameters were comparable. We conclude that minimally invasive liver resection with either PLAP or HALS\u2009+\u2009HYB technique yields excellent results.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-04998-w","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T17:13:56Z","timestamp":1554484436000},"page":"2025-2037","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Propensity Score\u2010Matched Analysis of Pure Laparoscopic Versus Hand\u2010Assisted\/Hybrid Major Hepatectomy at Two Western Centers"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1186-1979","authenticated-orcid":false,"given":"G.","family":"Fiorentini","sequence":"first","affiliation":[{"name":"Hepatobiliary Surgery Division San Raffaele Hospital (HSR), Ospedale San Raffaele Via Olgettina 58 20132 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Swaid","sequence":"additional","affiliation":[{"name":"Liver Cancer Center University of Pittsburgh Medical Center (UPMC) Pittsburgh USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Cipriani","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery Division San Raffaele Hospital (HSR), Ospedale San Raffaele Via Olgettina 58 20132 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Ratti","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery Division San Raffaele Hospital (HSR), Ospedale San Raffaele Via Olgettina 58 20132 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Heres","sequence":"additional","affiliation":[{"name":"Liver Cancer Center University of Pittsburgh Medical Center (UPMC) Pittsburgh USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Tsung","sequence":"additional","affiliation":[{"name":"Liver Cancer Center University of Pittsburgh Medical Center (UPMC) Pittsburgh USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Aldrighetti","sequence":"additional","affiliation":[{"name":"Hepatobiliary Surgery Division San Raffaele Hospital (HSR), Ospedale San Raffaele Via Olgettina 58 20132 Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. 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