Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis

Abstract Background Recent advances in ultrasound technology have led to widespread adoption of ultrasonic energy devices in liver resections. While various studies have assessed the comparative advantages of ultrasonic devices and traditional clamp-crushing, their findings vary. Moreover, a specifi...

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Main Authors: Zhang-neng Yu, Liang-liang Xu, Lian Li, Hua Zhang, Yong-yuan Ma, Liang Wang, Jin-ting Jiang, Ming Zhang
Format: Article
Language:English
Published: BMC 2024-11-01
Series:World Journal of Surgical Oncology
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Online Access:https://doi.org/10.1186/s12957-024-03575-3
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author Zhang-neng Yu
Liang-liang Xu
Lian Li
Hua Zhang
Yong-yuan Ma
Liang Wang
Jin-ting Jiang
Ming Zhang
author_facet Zhang-neng Yu
Liang-liang Xu
Lian Li
Hua Zhang
Yong-yuan Ma
Liang Wang
Jin-ting Jiang
Ming Zhang
author_sort Zhang-neng Yu
collection DOAJ
description Abstract Background Recent advances in ultrasound technology have led to widespread adoption of ultrasonic energy devices in liver resections. While various studies have assessed the comparative advantages of ultrasonic devices and traditional clamp-crushing, their findings vary. Moreover, a specific systematic review on this topic has not yet been conducted. Objectives This study aims to present a comprehensive, up-to-date analysis comparing outcomes between ultrasonic devices and conventional clamp-crushing methods in liver resection, based on currently available literature. Patients and methods We conducted a systematic literature search in databases such as PubMed, Embase, Web of Science, and CNKI up to November 2023. Studies that compared the efficacy or safety of ultrasonic devices against traditional clamp-crushing methods in hepatectomy were included. The analysis covered intraoperative outcomes like operating time, blood loss, and transfusion rate, as well as postoperative outcomes such as complication rate, mortality, postoperative bleeding, and bile leakage. Review Manager version 5.3 (Cochrane Collaboration, Oxford, UK) and Stata 17.0 (Stata Corp, College Station, TX, USA) were used for data analysis. Results Thirteen studies, involving a total of 1,417 patients (630 using ultrasonic devices and 787 using clamp-crushing methods), were included. The clamp-crush method resulted in a shorter operation time. Contrarily, the ultrasonic device group experienced reduced blood loss and lower transfusion rates. Postoperatively, there was no significant difference in mortality or postoperative bleeding between the groups. However, the ultrasonic group had a lower overall complication rate, particularly a reduced incidence of bile leakage. Overall, the ultrasonic devices were associated with improved perioperative outcomes. Conclusions The findings suggest that ultrasonic devices provide better outcomes in hepatectomy compared to traditional clamp-crushing techniques. Nonetheless, large-scale randomized controlled trials are needed to confirm these results due to potential heterogeneity and biases. The choice of using ultrasonic devices should consider the surgeon’s experience and individual patient circumstances.
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spelling doaj-art-c3ef7966b1824e989dcf2e316c834d532024-11-17T12:31:28ZengBMCWorld Journal of Surgical Oncology1477-78192024-11-0122111210.1186/s12957-024-03575-3Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysisZhang-neng Yu0Liang-liang Xu1Lian Li2Hua Zhang3Yong-yuan Ma4Liang Wang5Jin-ting Jiang6Ming Zhang7Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityKey Laboratory of Birth Defects and Related Diseases of Women and Children of MOE, West China Second University Hospital, Sichuan UniversityWest China School of Medicine, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityWest China School of Medicine, Sichuan UniversityDivision of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan UniversityAbstract Background Recent advances in ultrasound technology have led to widespread adoption of ultrasonic energy devices in liver resections. While various studies have assessed the comparative advantages of ultrasonic devices and traditional clamp-crushing, their findings vary. Moreover, a specific systematic review on this topic has not yet been conducted. Objectives This study aims to present a comprehensive, up-to-date analysis comparing outcomes between ultrasonic devices and conventional clamp-crushing methods in liver resection, based on currently available literature. Patients and methods We conducted a systematic literature search in databases such as PubMed, Embase, Web of Science, and CNKI up to November 2023. Studies that compared the efficacy or safety of ultrasonic devices against traditional clamp-crushing methods in hepatectomy were included. The analysis covered intraoperative outcomes like operating time, blood loss, and transfusion rate, as well as postoperative outcomes such as complication rate, mortality, postoperative bleeding, and bile leakage. Review Manager version 5.3 (Cochrane Collaboration, Oxford, UK) and Stata 17.0 (Stata Corp, College Station, TX, USA) were used for data analysis. Results Thirteen studies, involving a total of 1,417 patients (630 using ultrasonic devices and 787 using clamp-crushing methods), were included. The clamp-crush method resulted in a shorter operation time. Contrarily, the ultrasonic device group experienced reduced blood loss and lower transfusion rates. Postoperatively, there was no significant difference in mortality or postoperative bleeding between the groups. However, the ultrasonic group had a lower overall complication rate, particularly a reduced incidence of bile leakage. Overall, the ultrasonic devices were associated with improved perioperative outcomes. Conclusions The findings suggest that ultrasonic devices provide better outcomes in hepatectomy compared to traditional clamp-crushing techniques. Nonetheless, large-scale randomized controlled trials are needed to confirm these results due to potential heterogeneity and biases. The choice of using ultrasonic devices should consider the surgeon’s experience and individual patient circumstances.https://doi.org/10.1186/s12957-024-03575-3Liver neoplasmLiver resectionUltrasonicClamp
spellingShingle Zhang-neng Yu
Liang-liang Xu
Lian Li
Hua Zhang
Yong-yuan Ma
Liang Wang
Jin-ting Jiang
Ming Zhang
Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
World Journal of Surgical Oncology
Liver neoplasm
Liver resection
Ultrasonic
Clamp
title Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
title_full Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
title_fullStr Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
title_full_unstemmed Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
title_short Comparison of the outcomes between ultrasonic devices and clamping in hepatectomy: a meta-analysis
title_sort comparison of the outcomes between ultrasonic devices and clamping in hepatectomy a meta analysis
topic Liver neoplasm
Liver resection
Ultrasonic
Clamp
url https://doi.org/10.1186/s12957-024-03575-3
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