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Langenbeck's Archives of Surgery

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17.01.2022 | Systematic Reviews and Meta-analyses

The risk factors of intraoperative conversion during laparoscopic hepatectomy: a systematic review and meta-analysis

verfasst von: Lian Li, Liangliang Xu, Peng Wang, Ming Zhang, Bo Li

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 2/2022

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Abstract

Purpose

Intraoperative conversion to laparotomy is a challenge during laparoscopic hepatectomy; however, the risk factors of conversion have been poorly elucidated.

Methods

In this systematic review and meta-analysis, we computed pooled odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor and evaluated heterogeneity using a L’Abbe plot, Galbraith radial plot, Cochran’s Q test, and I². An extended funnel plot was used to evaluate the robustness of the results of meta-analysis. Sensitivity analysis and subgroup analysis were performed to determine sources of heterogeneity. Egger’s test and Begg’s test were used to assess publication bias.

Results

A total of 25 eligible studies were enrolled in the meta-analysis. Higher body mass index (OR 1.346, 95% CI 1.055–1.717), hypertension (OR 1.387, 95% CI 1.100–1.749), male sex (OR 1.278, 95% CI 1.072–1.523), cirrhosis (OR 1.378, 95% CI 1.062–1.788), major resection (OR 2.041, 95% CI 1.748–2.382), posterosuperior tumor location (OR 2.420, 95% CI 1.923–3.044), and larger tumor diameter (OR 1.618, 95% CI 1.270–2.061) were found to be significantly related to intraoperative conversion during laparoscopic hepatectomy. Malignant tumor (OR 1.253, 95% CI 0.970–1.619), higher American Society of Anesthesiologists stage (OR 1.186, 95% CI 0.863–1.631), multiple tumors (OR 1.273, 95% CI 0.866–1.871), and abdominal surgery history (OR 1.236, 95% CI 0.589–2.597) were not associated with conversion. A history of abdominal surgery showed significant heterogeneity with an I² of 80.8% (p < 0.001). Subgroup analysis indicated that heterogeneity was caused by the different number of patients among enrolled studies.

Conclusions

In this systematic review and meta-analysis, we identified a number of factors associated with intraoperative conversion during laparoscopic hepatectomy. Our findings can help patient risk evaluation to reduce the laparotomy conversion rate in laparoscopic hepatectomy.

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Titel: The risk factors of intraoperative conversion during laparoscopic hepatectomy: a systematic review and meta-analysis
verfasst von: Lian Li
Liangliang Xu
Peng Wang
Ming Zhang
Bo Li
Publikationsdatum: 17.01.2022
Verlag: Springer Berlin Heidelberg
Erschienen in: Langenbeck's Archives of Surgery / Ausgabe 2/2022
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-022-02435-6

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The risk factors of intraoperative conversion during laparoscopic hepatectomy: a systematic review and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

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