B Alkari1, A Owera, B J Ammori. 1. Department of Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
Abstract
BACKGROUND AND AIMS: Advancements in surgical technique and technology have facilitated safe laparoscopic liver resection in selected patients. The aim of this study is to evaluate the feasibility and outcome of laparoscopic liver resection. METHODS: Patients with lesions situated in the anterior and left lateral segments were selected for laparoscopic resection. Data were collected prospectively. RESULTS: Between 2003 and 2007, 24 patients (12 males) with a median (range) age of 65 (30-83) years underwent 24 laparoscopic hepatic resections for presumed colorectal metastases (n=20) and other indications (n=4). The resections included left hepatic lobectomy (n=14), other resections of two or three segments with or without metastasectomy (n=5), left hemihepatectomy (n=2) and unisegmentectomy (n=3). All procedures were completed laparoscopically. Median operating time was 155 min. Estimated median (range) blood loss was 100 (25-1100) ml and one patient received two units blood transfusion. The operative morbidity rate was 4%, and there were no operative deaths. The median (range) postoperative hospital stay was 3 (1-14) days. At median (range) follow-up of 13.5 (5-36) months, 4 patients (21%) had disease recurrence and 17 patients (89%) remained alive. CONCLUSIONS: In selected patients with lesions in the anterior and left lateral segments, laparoscopic liver resection is feasible, achieves adequate cancer resection and is associated with smooth and rapid recovery. Long-term follow-up data are required for oncological results.
BACKGROUND AND AIMS: Advancements in surgical technique and technology have facilitated safe laparoscopic liver resection in selected patients. The aim of this study is to evaluate the feasibility and outcome of laparoscopic liver resection. METHODS:Patients with lesions situated in the anterior and left lateral segments were selected for laparoscopic resection. Data were collected prospectively. RESULTS: Between 2003 and 2007, 24 patients (12 males) with a median (range) age of 65 (30-83) years underwent 24 laparoscopic hepatic resections for presumed colorectal metastases (n=20) and other indications (n=4). The resections included left hepatic lobectomy (n=14), other resections of two or three segments with or without metastasectomy (n=5), left hemihepatectomy (n=2) and unisegmentectomy (n=3). All procedures were completed laparoscopically. Median operating time was 155 min. Estimated median (range) blood loss was 100 (25-1100) ml and one patient received two units blood transfusion. The operative morbidity rate was 4%, and there were no operative deaths. The median (range) postoperative hospital stay was 3 (1-14) days. At median (range) follow-up of 13.5 (5-36) months, 4 patients (21%) had disease recurrence and 17 patients (89%) remained alive. CONCLUSIONS: In selected patients with lesions in the anterior and left lateral segments, laparoscopic liver resection is feasible, achieves adequate cancer resection and is associated with smooth and rapid recovery. Long-term follow-up data are required for oncological results.
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