A systematic review of Minimally Invasive Trans-Thoracic Liver Resection (MITTLR) to examine intervention description, governance and outcome reporting of an innovative technique

Samir Pathak, Barry G Main, Natalie S Blencowe, Jonathan R E Rees, Harry F Robertson, Reyad A G Abbadi, Jane M Blazeby

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

Introduction
The number of laparoscopic liver resections undertaken has increased. However, lesions located postero-superiorly are difficult to access. This may be overcome by the novel use of transthoracic port(s). Methods for the safe and transparent introduction of new and modified surgical procedures are limited and a summary of these issues, for minimally invasive trans thoracic liver resections (MITTLR), is lacking. This study aims to understand and summarize technique description, governance procedures and reporting of outcomes for MITTLR.

Methods
A systematic literature search to identify primary studies of all designs describing MITTLR was undertaken. How patients were selected for the new technique was examined. The technical components of MITTLR were identified and summarized to understand technique development over time. Governance arrangements (e.g. IRB approval) and steps taken to mitigate harm were recorded. Finally, specific outcomes reported across studies were documented.

Results
Of 2067 83 screened articles, 16 were included reporting data from 145 patients and six countries. Selection criteria for patients was explicitly stated in two papers. No studies fully described the technique. Five papers reported ethical approval and three gave details of patient consent. No study reported on steps taken to mitigate harm. Technical outcomes were commonly reported e.g. blood loss (15/16 studies), operative time (15/16) and margin status (11/16). Information on patient reported outcomes and costs were
lacking.

Conclusions
Technical details and governance procedures were poorly described. Outcomes focussed on short term details alone. Transparency is needed for reporting the introduction of new surgical techniques to allow their safe dissemination
Original languageEnglish
JournalAnnals of Surgery
Early online date4 Jun 2020
DOIs
Publication statusE-pub ahead of print - 4 Jun 2020

Fingerprint Dive into the research topics of 'A systematic review of Minimally Invasive Trans-Thoracic Liver Resection (MITTLR) to examine intervention description, governance and outcome reporting of an innovative technique'. Together they form a unique fingerprint.

Cite this