Hiroaki Fuji1, Etsuro Hatano1,2, Satoru Seo1, Akira Arimoto3, Michio Okabe4, Takahisa Fujikawa5, Ryuta Nishitai6, Takamichi Ishii7, Satoshi Kaihara8, Takakazu Matsushita9, Fumitaka Oike10, Masato Ichimiya11, Shuichi Ohta12, Kenya Yamanaka13, Kojiro Taura1, Kentaro Yasuchika1, Shinji Uemoto1. 1. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 2. Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan. 3. Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan. 4. Department of Surgery, Kurashiki Central Hospital, Kurashiki, Japan. 5. Department of Surgery, Kokura Memorial Hospital, Kitakyu-shu, Japan. 6. Department of Surgery, Kyoto Katsura Hospital, Kyoto, Japan. 7. Department of Surgery, Nishi Kobe Medical Center, Kobe, Japan. 8. Department of Surgery, Kobe City Medical Center General Hospital, Kobe, Japan. 9. Department of Surgery, National Hospital Organization Himeji Medical Center, Himeji, Japan. 10. Department of Surgery, Mitsubishi Kyoto Hospital, Kyoto, Japan. 11. Department of Surgery, Japan Red Cross Wakayama Medical Center, Wakayama, Japan. 12. Department of Surgery, Osakafu Saiseikai Noe Hospital, Osaka, Japan. 13. Department of Surgery, Kishiwada City Hospital, Kishiwada, Japan.
Abstract
INTRODUCTION: Laparoscopic liver resection (LLR) has been widely performed throughout the world. Although prospective registry studies to clarify the safety of LLR have been feasible, no prior multicenter prospective study has addressed this issue. We have conducted a multicenter prospective cohort study to reveal the current status of LLR in Japan. METHODS: From April 2015 to March 2016, candidates for LLR were preoperatively enrolled at 12 institutions. The primary end-point was surgical safety, which was evaluated based on surgical factors and on short-term and midterm outcomes. RESULTS: A total of 102 patients were enrolled. Planned laparoscopic procedures included 96 pure laparoscopies, 1 hand-assisted laparoscopy, and 5 hybrid techniques. Non-anatomical partial resection or left lateral sectionectomy were performed in almost all cases. The median duration of surgery was 221 min. The median blood loss was 80.5 mL. Conversion was required for four patients (3.9%). The 90-day postoperative morbidities with grades more severe than II in the Clavien-Dindo classification were observed in six patients (5.9%). The median postoperative hospital stay was 9.5 days. No cases involved reoperation or mortality. CONCLUSION: Minor resection of LLR has been performed safely. To ensure the safe dissemination of LLR, including for major resection, a larger multicenter prospective study is required.
INTRODUCTION: Laparoscopic liver resection (LLR) has been widely performed throughout the world. Although prospective registry studies to clarify the safety of LLR have been feasible, no prior multicenter prospective study has addressed this issue. We have conducted a multicenter prospective cohort study to reveal the current status of LLR in Japan. METHODS: From April 2015 to March 2016, candidates for LLR were preoperatively enrolled at 12 institutions. The primary end-point was surgical safety, which was evaluated based on surgical factors and on short-term and midterm outcomes. RESULTS: A total of 102 patients were enrolled. Planned laparoscopic procedures included 96 pure laparoscopies, 1 hand-assisted laparoscopy, and 5 hybrid techniques. Non-anatomical partial resection or left lateral sectionectomy were performed in almost all cases. The median duration of surgery was 221 min. The median blood loss was 80.5 mL. Conversion was required for four patients (3.9%). The 90-day postoperative morbidities with grades more severe than II in the Clavien-Dindo classification were observed in six patients (5.9%). The median postoperative hospital stay was 9.5 days. No cases involved reoperation or mortality. CONCLUSION: Minor resection of LLR has been performed safely. To ensure the safe dissemination of LLR, including for major resection, a larger multicenter prospective study is required.