Taiga Wakabayashi1,2, Emanuele Felli1,3,4, Riccardo Memeo1,3,5,4, Pietro Mascagni4, Yuta Abe2, Yuko Kitagawa2, Patrick Pessaux6,7,8. 1. Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. 2. Department of Surgery, Keio University School of Medicine, Tokyo, Japan. 3. Department of General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France. 4. Institute of Minimally Invasive Hybrid Image-Guided Surgery, Institut Hospitalo-Universitaire (IHU), Université de Strasbourg, Strasbourg, France. 5. Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy. 6. Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. 7. Department of General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Université de Strasbourg, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr. 8. Institute of Minimally Invasive Hybrid Image-Guided Surgery, Institut Hospitalo-Universitaire (IHU), Université de Strasbourg, Strasbourg, France. patrick.pessaux@chru-strasbourg.fr.
Abstract
BACKGROUND: Laparoscopic repeat liver resection (LRLR) still represents a challenge for surgeons especially in case with previous open liver surgery. The aim of the study is to perform a systematic review of the current literature to investigate the feasibility of LRLR after open liver resection (OLR) for liver diseases. METHODS: A computerized search was performed for all English language studies evaluating LRLR. A meta-analysis was performed to evaluate the short-term outcomes in comparative studies between LRLR with previous laparoscopic liver resection (LLR) and OLR. RESULTS: From the initial 55 manuscripts, 8 studies including 3 comparative studies between LRLR after OLR and LLR were investigated. There was a total of 108 patients. Considering initial surgery, the extent of initial liver resection was major liver resection in 20% of patients in whom it was reported. In all the patients, the most frequent primary histology was hepatocellular carcinoma, followed by colorectal liver metastasis. A half of reported patients had severe adhesions at the time of LRLR. The median operative time for LRLR was ranged from 120 to 413 min and the median blood loss ranged from 100 to 400 mL. There were 11% of the patients conversions to open surgery, hand-assisted laparoscopic surgery, or tumor ablation. The overall postoperative morbidity was 15% of all the patients, and there was no postoperative mortality. The median postoperative hospital stay was ranged from 3.5 to 10 days. The meta-analysis shows that LRLR after OLR is associated with a longer operative time and a more important blood loss compared to LRLR after LLR. However, no difference between LRLR after OLR and LLR was shown as far as hospital stay and morbidity rate are concerned. CONCLUSIONS: LRLR after OLR has been described in eight articles with favorable short-term outcomes in highly selected patients.
BACKGROUND: Laparoscopic repeat liver resection (LRLR) still represents a challenge for surgeons especially in case with previous open liver surgery. The aim of the study is to perform a systematic review of the current literature to investigate the feasibility of LRLR after open liver resection (OLR) for liver diseases. METHODS: A computerized search was performed for all English language studies evaluating LRLR. A meta-analysis was performed to evaluate the short-term outcomes in comparative studies between LRLR with previous laparoscopic liver resection (LLR) and OLR. RESULTS: From the initial 55 manuscripts, 8 studies including 3 comparative studies between LRLR after OLR and LLR were investigated. There was a total of 108 patients. Considering initial surgery, the extent of initial liver resection was major liver resection in 20% of patients in whom it was reported. In all the patients, the most frequent primary histology was hepatocellular carcinoma, followed by colorectal liver metastasis. A half of reported patients had severe adhesions at the time of LRLR. The median operative time for LRLR was ranged from 120 to 413 min and the median blood loss ranged from 100 to 400 mL. There were 11% of the patients conversions to open surgery, hand-assisted laparoscopic surgery, or tumor ablation. The overall postoperative morbidity was 15% of all the patients, and there was no postoperative mortality. The median postoperative hospital stay was ranged from 3.5 to 10 days. The meta-analysis shows that LRLR after OLR is associated with a longer operative time and a more important blood loss compared to LRLR after LLR. However, no difference between LRLR after OLR and LLR was shown as far as hospital stay and morbidity rate are concerned. CONCLUSIONS: LRLR after OLR has been described in eight articles with favorable short-term outcomes in highly selected patients.
Authors: J M Becker; M T Dayton; V W Fazio; D E Beck; S J Stryker; S D Wexner; B G Wolff; P L Roberts; L E Smith; S A Sweeney; M Moore Journal: J Am Coll Surg Date: 1996-10 Impact factor: 6.113
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Authors: Albert C Y Chan; Ronnie T P Poon; Kenneth S H Chok; Tan To Cheung; See Ching Chan; Chung Mau Lo Journal: World J Surg Date: 2014-05 Impact factor: 3.352