Laparoscopic repeat liver resection after open liver resection: A comparative study from a single-centre.
Difficulty score
laparoscopic
minor liver resection
previous open liver resection
repeat liver resection
short-term outcomes
Journal
Journal of minimal access surgery
ISSN: 0972-9941
Titre abrégé: J Minim Access Surg
Pays: India
ID NLM: 101228183
Informations de publication
Date de publication:
Historique:
pubmed:
5
9
2018
medline:
5
9
2018
entrez:
5
9
2018
Statut:
ppublish
Résumé
Technological innovations have made it possible to use laparoscopic liver resection in cases with pre-existing adhesions or cicatricial changes. However, laparoscopic repeat liver resection (LRLR) still represents a challenge for surgeons, especially in case of previous open liver surgery. This study evaluated the outcomes of LRLR after open liver resection (OLR) in cases of recurrent liver cancer. A total of 62 patients who underwent laparoscopic minor liver resection at our institution between September 2012 and September 2016 were retrospectively divided into an LRLR group (n = 13) and a laparoscopic primary liver resection group (LPLR; n = 49). The two groups were compared in terms of patient demographics, surgical procedures and short-term outcomes. Recurrence-free survival (RFS) and overall survival (OS) were compared for patients with hepatocellular carcinoma (HCC) or colorectal liver metastases (CRLMs). There was a significant intergroup difference in the hepatitis virus background, although the two groups' primary histology and pre-operative liver function were comparable. The two groups had statistically similar values for extent of resection, operative time, estimated blood loss, transfusion requirement, conversion to laparotomy, post-operative complications, surgical margins, time to oral intake and hospital stay. No significant differences were detected when we stratified the cases according to low and intermediate difficulty. Furthermore, there were no intergroup differences in RFS or OS in the two groups for patients with HCC and CRLM. The findings suggest that minor LRLR after OLR is safe and comparable with minor LPLR in the present study.
Sections du résumé
BACKGROUND
BACKGROUND
Technological innovations have made it possible to use laparoscopic liver resection in cases with pre-existing adhesions or cicatricial changes. However, laparoscopic repeat liver resection (LRLR) still represents a challenge for surgeons, especially in case of previous open liver surgery. This study evaluated the outcomes of LRLR after open liver resection (OLR) in cases of recurrent liver cancer.
MATERIALS AND METHODS
METHODS
A total of 62 patients who underwent laparoscopic minor liver resection at our institution between September 2012 and September 2016 were retrospectively divided into an LRLR group (n = 13) and a laparoscopic primary liver resection group (LPLR; n = 49). The two groups were compared in terms of patient demographics, surgical procedures and short-term outcomes. Recurrence-free survival (RFS) and overall survival (OS) were compared for patients with hepatocellular carcinoma (HCC) or colorectal liver metastases (CRLMs).
RESULTS
RESULTS
There was a significant intergroup difference in the hepatitis virus background, although the two groups' primary histology and pre-operative liver function were comparable. The two groups had statistically similar values for extent of resection, operative time, estimated blood loss, transfusion requirement, conversion to laparotomy, post-operative complications, surgical margins, time to oral intake and hospital stay. No significant differences were detected when we stratified the cases according to low and intermediate difficulty. Furthermore, there were no intergroup differences in RFS or OS in the two groups for patients with HCC and CRLM.
CONCLUSIONS
CONCLUSIONS
The findings suggest that minor LRLR after OLR is safe and comparable with minor LPLR in the present study.
Identifiants
pubmed: 30178770
pii: 240462
doi: 10.4103/jmas.JMAS_175_18
pmc: PMC6945330
doi:
Types de publication
Journal Article
Langues
eng
Pagination
59-65Déclaration de conflit d'intérêts
None
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