I Nachmany1, N Pencovich2, N Zohar2, A Ben-Yehuda2, C Binyamin2, Y Goykhman2, N Lubezky2, R Nakache2, J M Klausner2. 1. Department of General Surgery B, Division of General Surgery, Tel-Aviv Sourasky Medical Center, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: idon@tlvmc.gov.il. 2. Department of General Surgery B, Division of General Surgery, Tel-Aviv Sourasky Medical Center, The Nikolas & Elizabeth Shlezak Fund for Experimental Surgery, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Abstract
BACKGROUND: Application of minimally invasive surgery for oncologic liver resection is still limited to expert centers. We describe our experience in laparoscopic liver resection (LLR) for colorectal liver metastases (CLM). PATIENTS AND METHODS: Between February 2010 and February 2015, 174 patients underwent resection of CLM. LLR was chosen according to surgeon's preferences. Data was retrieved from the institutes' electronic charts and retrospectively analyzed. RESULTS: LLR was performed in 42 patients (24.5%) and OLR in 132. Increased number of metastases were found in OLR (2.82 ± 2.81 versus 1.78 ± 1.16, P = 0.02), with no difference in maximal lesion size (33.1 ± 22 versus 34.9 ± 27.5 cm, P = 0.7). Altogether 55 patients underwent major hepatectomy, and 50 of the OLR group (37.8%, 37 right hepatectomy and 7 left hepatectomy) (P = 0.02). In 5 patients (11.6%) a conversion to open surgery was indicated. Operative time was longer in LLR. Estimated blood loss was decreased in laparoscopic minor resections. One OLR patient died during the postoperative period (0.7%). Eight patients in the OLR group had major complications, versus 1 in the LLR group (P = 0.0016). Reoperation within 30 days was performed in 4 OLR patients and none in the LLR group. Patients in the LLR group had shorter length of stay (LOS) (6.78 ± 2.75 versus 8.39 ± 5.64 days, P = 0.038). R0 resection was 88% in both groups. CONCLUSIONS: In selected patients with CLM, LLR is feasible, safe and may achieve shorter LOS without inferior oncologic outcome.
BACKGROUND: Application of minimally invasive surgery for oncologic liver resection is still limited to expert centers. We describe our experience in laparoscopic liver resection (LLR) for colorectal liver metastases (CLM). PATIENTS AND METHODS: Between February 2010 and February 2015, 174 patients underwent resection of CLM. LLR was chosen according to surgeon's preferences. Data was retrieved from the institutes' electronic charts and retrospectively analyzed. RESULTS: LLR was performed in 42 patients (24.5%) and OLR in 132. Increased number of metastases were found in OLR (2.82 ± 2.81 versus 1.78 ± 1.16, P = 0.02), with no difference in maximal lesion size (33.1 ± 22 versus 34.9 ± 27.5 cm, P = 0.7). Altogether 55 patients underwent major hepatectomy, and 50 of the OLR group (37.8%, 37 right hepatectomy and 7 left hepatectomy) (P = 0.02). In 5 patients (11.6%) a conversion to open surgery was indicated. Operative time was longer in LLR. Estimated blood loss was decreased in laparoscopic minor resections. One OLR patient died during the postoperative period (0.7%). Eight patients in the OLR group had major complications, versus 1 in the LLR group (P = 0.0016). Reoperation within 30 days was performed in 4 OLR patients and none in the LLR group. Patients in the LLR group had shorter length of stay (LOS) (6.78 ± 2.75 versus 8.39 ± 5.64 days, P = 0.038). R0 resection was 88% in both groups. CONCLUSIONS: In selected patients with CLM, LLR is feasible, safe and may achieve shorter LOS without inferior oncologic outcome.
Authors: Ahmad Ozair; Amelia Collings; Alexandra M Adams; Rebecca Dirks; Bradley S Kushner; Iswanto Sucandy; David Morrell; Ahmed M Abou-Setta; Timothy Vreeland; Jake Whiteside; Jordan M Cloyd; Mohammed T Ansari; Sean P Cleary; Eugene Ceppa; William Richardson; Adnan Alseidi; Ziad Awad; Subhashini Ayloo; Joseph F Buell; Georgios Orthopoulos; Samer Sbayi; Go Wakabayashi; Bethany J Slater; Aurora Pryor; D Rohan Jeyarajah Journal: Surg Endosc Date: 2022-09-22 Impact factor: 3.453
Authors: Marc G Besselink; Mohammed Abu Hilal; Nicky van der Heijde; Francesca Ratti; Luca Aldrighetti; Andrea Benedetti Cacciaguerra; Mehmet F Can; Mathieu D'Hondt; Fabrizio Di Benedetto; Arpad Ivanecz; Paolo Magistri; Krishna Menon; Michail Papoulas; Marco Vivarelli Journal: Surg Endosc Date: 2020-11-02 Impact factor: 4.584
Authors: Christian Benzing; Felix Krenzien; Georgi Atanasov; Daniel Seehofer; Robert Sucher; Ricardo Zorron; Johann Pratschke; Moritz Schmelzle Journal: GMS Interdiscip Plast Reconstr Surg DGPW Date: 2015-12-15