The likelihood of a textbook outcome in liver surgery is comparable with minimally invasive hepatectomy versus open hepatectomy, according to results published in the Journal of Gastrointestinal Surgery. Timothy M. Pawlik, MD, PHD, MPH, and colleagues examined whether minimally invasive hepatectomy (MIH) was superior to open hepatectomy (OH) for achieving a textbook outcome in liver surgery (TOLS) after hepatocellular carcinoma resection. Of 1,039 patients, most (n=724; 69.7%) underwent OH. Tumor burden scores were lower with MIH (3.6) versus OH (6.1); minor hepatectomy was also more likely with MIH (84.1%) than OH (53.6%; both P<0.001). Following propensity score matching to control for baseline differences, TOLS incidence was comparable with MIH versus OH (56.6% vs 64.8%). However, MIH was associated with a shorter hospital stay versus OH (6.0 vs 9.0 days). Among patients with MIH, the odds ratio of achieving TOLS was stable up to a tumor burden score of 4, after which the likelihood markedly declined.
