In a systematic review of six randomized controlled trials involving 736 patients, the anterior approach with or without liver hanging maneuver demonstrated significant survival benefits over conventional techniques. Overall and disease-free survival rates improved markedly (HR: 0.65; p < 0.0001). Although associated with longer surgery times (WMD: 29.5 min; p = 0.004), this approach resulted in reduced intraoperative blood loss (WMD: 24.3; p = 0.0014). Other postoperative outcomes showed no significant differences.
Review by Granieri S, Frassini S (…) Cotsoglou C et 10 al. in Eur J Surg Oncol
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