Hepatic Pedicle Clamping Does Not Worsen Survival after Hepatic Resection for Colorectal Liver Metastasis: Results from a Systematic Review and Meta-analysis

Akihisa Matsuda, Masao Miyashita, Satoshi Matsumoto, Takeshi Matsutani, Nobuyuki Sakurazawa, Ichiro Akagi, Taro Kishi, Kimiyoshi Yokoi, Eiji Uchida

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: Hepatic pedicle clamping (HPC) has been demonstrated to be effective for short-term outcomes during hepatic resection. However, HPC-induced hepatic ischemia/reperfusion injury can accelerate the outgrowth of hepatic micrometastases in experimental studies. The conclusive evidence regarding effects of HPC on long-term patient outcomes after hepatic resection for colorectal liver metastasis (CRLM) has not been determined. Methods: A comprehensive electronic literature search was performed to identify studies evaluating the oncological effects of HPC after hepatic resection for CRLM. The main outcome measures were intrahepatic recurrence (IHR), disease-free survival (DFS), and overall survival (OS). A meta-analysis was performed using the random-effects models to compute odds ratio (OR) along with 95 % confidence intervals (CI). Results: Four studies, with a total of 2,114 patients (73.7 % HPC, 26.3 % non-HPC), matched the inclusion criteria. Meta-analyses revealed that IHR (OR 0.88; 95 % CI 0.69-1.11; P = 0.27), DFS (OR 0.88; 95 % CI 0.70-1.10; P = 0.27) and OS (OR 0.99; 95 % CI 0.79-1.24; P = 0.90) did not differ significantly between the HPC and non-HPC groups. Conclusions: This meta-analysis provides persuasive evidence that HPC during hepatic resection for CRLM has no significant adverse oncological outcomes. HPC should be considered an option during parenchymal liver resection from current available evidence.

Original languageEnglish
Pages (from-to)3771-3778
Number of pages8
JournalAnnals of Surgical Oncology
Volume20
Issue number12
DOIs
Publication statusPublished - 11-2013

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Fingerprint Dive into the research topics of 'Hepatic Pedicle Clamping Does Not Worsen Survival after Hepatic Resection for Colorectal Liver Metastasis: Results from a Systematic Review and Meta-analysis'. Together they form a unique fingerprint.

Cite this