A Prospective Evaluation of Laparoscopic Versus Open Left Lateral Hepatic Sectionectomy

Aldrighetti, Luca; Pulitanò, Carlo; Catena, Marco; Arru, Marcella; Guzzetti, Eleonora; Casati, Massimiliano; Comotti, Laura; Ferla, Gianfranco

doi:10.1007/s11605-007-0244-6

Cited by 106 publications

(99 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The first two issues were addressed early in the first part of this decade [2,15,16,17] and oncological efficiency has been recently demonstrated [1,21,22,23,24,25]. However, surgical indications continue to raise concerns especially for the treatment of benign liver lesions.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical Management of Benign and Indeterminate Hepatic Lesions in the Era of Laparoscopic Liver Surgery

Hilal¹,

Fabio²,

Teng³

et al. 2011

Dig Surg

View full text Add to dashboard Cite

Background/Aims: The expansion of the laparoscopic approach for the management of benign liver lesions has raised concerns regarding the risk of widening surgical indications and compromising safety. Large single-centre series focusing on laparoscopic management of benign liver lesions are sporadic. Methods: We reviewed a prospectively collected database of patients undergoing pure laparoscopic liver resection (LLR) for benign liver lesions. All cases were individually discussed at a multidisciplinary team meeting. Results: Forty-six patients underwent 50 LLRs for benign disease. Indications for surgery were: symptomatic lesions, preoperative diagnosis of adenoma or cystadenoma, and lesions with an indeterminate diagnosis. The preoperative diagnosis was uncertain in 11 cases. Of these, histological diagnosis was hepatocellular carcinoma in one (9%) and benign lesion in 10 patients (91%). Thirteen patients (28%) required major hepatectomy. Three patients (7%) developed postoperative complications. Mortality was nil. The median postoperative hospital stay following major and minor hepatectomy was 4 and 3 days, respectively. Conclusion: The laparoscopic approach represents a safe option for the management of benign and indeterminate liver lesions, even when major hepatectomy is required. LLR should be only performed in specialized centres to ensure safety and strict adherence to orthodox surgical indication.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This appeared appropriate especially when considering initial concerns regarding tumour dissemination, incomplete tumour resections and involved margins [2,17,18,19,20]. Several centres have now demonstrated the oncological efficiency of the laparoscopic approach [1,21,22,23,24]. …”

Section: Introductionmentioning

confidence: 99%

Surgical Management of Benign and Indeterminate Hepatic Lesions in the Era of Laparoscopic Liver Surgery

Hilal¹,

Fabio²,

Teng³

et al. 2011

Dig Surg

View full text Add to dashboard Cite

show abstract

“…In our series no laparoscopic patient had a R1 resection, and the width of free margin did not differ between the two groups (laparoscopy vs. open: 11 mm vs. 7 mm). Intraoperative ultrasonography was used in all patients, and helped to show the tumor extent, its relationship with vessels, and the eventual presence of satellitosis, achieving a clear margin in absence of tactile sensation [15,16]. Another concern about laparoscopic resection of malignancies is the risk of port site tumor recurrence, which was not recorded in our patients.…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Aldrighetti

Guzzetti

Pulitanò

et al. 2010

Journal of Surgical Oncology

Self Cite

135

View full text Add to dashboard Cite

Background and Objectives: Laparoscopy is gaining acceptance as a safe procedure for resection of liver neoplasms. The aim of this study is to evaluate surgical results and mid-term survival of minor hepatic resection performed for HCC. Methods: Data of 16 patients with HCC, undergoing laparoscopic hepatectomy from September 2005 to January 2009, were compared to a control group of 16 patients who underwent open resection (OR) during the same period. The two groups were matched in terms of type of resection, tumor size, and severity of cirrhosis. Results: One patient underwent conversion to an open approach. Laparoscopic approach resulted in shorter operating time (150 min, P:0.044) and lower blood loss (258 ml, P:0.008). There was no difference in perioperative morbidity and mortality rate; laparoscopic approach was associated with a shorter hospital stay (6.3 days, P:0.039). After a mean follow up of 32 months, disease free survival and overall survival were 40.2 and 23.3 months for laparoscopic group, and 47.7 and 31.4 months for OR group (P NS). Conclusion: Laparoscopic resection of HCC is feasible and safe in selected patients and can result in good surgical results, with similar outcomes in terms of overall and disease-free survival.

show abstract

“…Previous studies reported that the laparoscopic approach was associated with a shorter length of hospital stay irrespective of the indication, a lower transfusion rate and earlier recovery in patients with benign condition or primary malignancy, even in cirrhotic patients. [5][6][7] This study has the inherited limitations of the retrospective study with small number of patients. The selection criteria for laparoscopic and open surgery were not presented clearly.…”

Section: Editorialmentioning

confidence: 99%

Outcomes of Laparoscopic Versus Open Left Lateral Sectionectomy; Single Center Experience; A Initiative to Be the Ground for Evidence

Choi

Yoon

2017

J Minim Invasive Surg

View full text Add to dashboard Cite

EDITORIALSince the first international consensus conference in 2008, 1 laparoscopic liver resection (LLR) has been rapidly disseminated. With improvement of surgical technique and development of laparoscopic device, indications have expanded from minor liver resection to more complicated cases, including major liver resection and living donor hepatectomy.2 Advantages of LLR include less blood loss, smaller incisions, less abdominal wall complications, decreased postoperative morbidity, and shorter length of stay compared to open liver resection. With well-documented these advantages, laparoscopic left lateral sectionectomy and minor liver resection are now considered as a standard procedure worldwide.3 Along with this situation, there has been an exponential growth in the number of LLR in Korea. In Korean national survey in 2012, left lateral sectionectomy accounted for approximately 30% of all laparoscopic liver resections. 4 This study compared the outcomes of laparoscopic and open left lateral sectionectomy based on retrospective analysis of a single-center experience. Previous studies reported that the laparoscopic approach was associated with a shorter length of hospital stay irrespective of the indication, a lower transfusion rate and earlier recovery in patients with benign condition or primary malignancy, even in cirrhotic patients. [5][6][7] This study has the inherited limitations of the retrospective study with small number of patients. The selection criteria for laparoscopic and open surgery were not presented clearly. The surgical and oncologic outcomes for various diseases were mixed. Nevertheless, authors presented valuable data with a specific focus on left lateral sectionectomy of a Korean institution that early adopted this operative procedure. The initial time of the study period (from 2008 to 2015) was when there was still controversy about the application of LLR, especially for malignancy in Korea. The results of this study reconfirmed the advantage of laparoscopic left lateral sectionectomy in that it was associated with less bleeding and shorter hospital stay compared to open surgery. Moreover, the authors pointed out the necessity of large-scale prospective studies or national registry to overcome the limited evidence based on smallscale single center research. This study is meaningful as a preliminary study which will be the basis for further multicenter collaborative studies. We hope that a collection of small retrospective studies like this study will be the ground to develop evidence for generalization of laparoscopic left lateral sectionectomy.

show abstract

A Prospective Evaluation of Laparoscopic Versus Open Left Lateral Hepatic Sectionectomy

Abstract: Laparoscopic resection results in reduced operative blood loss and earlier recovery with oncologic clearance and operative time comparable with open surgery. Laparoscopic liver surgery may be considered the approach of choice for tumors located in the left hepatic lobe.

Cited by 106 publications

References 15 publications

Surgical Management of Benign and Indeterminate Hepatic Lesions in the Era of Laparoscopic Liver Surgery

Surgical Management of Benign and Indeterminate Hepatic Lesions in the Era of Laparoscopic Liver Surgery

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Outcomes of Laparoscopic Versus Open Left Lateral Sectionectomy; Single Center Experience; A Initiative to Be the Ground for Evidence

Contact Info

Product

Resources

About