Abstract:IntroductionThe liver is the most common site of colorectal metastases (colorectal liver metastases – CLM). Surgical treatment in combination with oncological therapy is the only potentially curative method. Unfortunately, only 10–25% of patients are suitable for surgery. Traditionally, open liver resection (OLR) is usually performed. However, laparoscopic liver resection (LLR) has become popular worldwide in the last two decades.AimTo evaluate the effectiveness and benefits of radiofrequency minor LLR of CLM … Show more
“…A previous study reported that definite ablation can be achieved for tumors with a diameter of < 3 cm. However, tumors measuring > 3 cm are associated with the possibility of incomplete ablation, which is consistent with the results of this research [ 16 – 19 ]. The minimally invasive and reproducible nature of laparoscopic microwave ablation entails no significant differences in terms of ablation effect and follow-up results between patients receiving a second ablation and those with tumors measuring < 3 cm in diameter.…”
IntroductionLiver cancer is one of the most common malignancies of the digestive system. Minimally invasive ablation procedures have become one of the major means for treating unresectable multifocal liver cancer and have been extensively applied in primary and metastatic liver cancer treatment. Laparoscopic B-ultrasound-guided microwave ablation is an example of the progress made in this field.AimTo analyze and summarize the results of and experience with laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer; moreover, the ablation effects were compared between tumors of different sizes.Material and methodsLaparoscope-guided needle ablation was conducted on 84 lesions from 32 patients with primary liver cancer based on tumor size, quantity, and location. Moreover, the perioperative data, ablation effects according to tumor size, and long-term follow-up results were analyzed.ResultsAmong the 84 nodules treated via microwave ablation, tumors measuring ≤ 3 cm demonstrated complete ablation upon imaging analysis conducted 1 month after surgery. Moreover, 5 of the tumors measuring > 3 cm demonstrated incomplete ablation. In these cases, a second procedure was performed, until imaging studies confirmed that complete ablation was achieved.ConclusionsLaparoscopic microwave ablation allows for precise puncture positioning, an effective ablation range, and safe and feasible surgery, which is especially suitable for liver tumors located in sites difficult to access.
“…A previous study reported that definite ablation can be achieved for tumors with a diameter of < 3 cm. However, tumors measuring > 3 cm are associated with the possibility of incomplete ablation, which is consistent with the results of this research [ 16 – 19 ]. The minimally invasive and reproducible nature of laparoscopic microwave ablation entails no significant differences in terms of ablation effect and follow-up results between patients receiving a second ablation and those with tumors measuring < 3 cm in diameter.…”
IntroductionLiver cancer is one of the most common malignancies of the digestive system. Minimally invasive ablation procedures have become one of the major means for treating unresectable multifocal liver cancer and have been extensively applied in primary and metastatic liver cancer treatment. Laparoscopic B-ultrasound-guided microwave ablation is an example of the progress made in this field.AimTo analyze and summarize the results of and experience with laparoscopic B-ultrasound-guided microwave ablation for multifocal primary liver cancer; moreover, the ablation effects were compared between tumors of different sizes.Material and methodsLaparoscope-guided needle ablation was conducted on 84 lesions from 32 patients with primary liver cancer based on tumor size, quantity, and location. Moreover, the perioperative data, ablation effects according to tumor size, and long-term follow-up results were analyzed.ResultsAmong the 84 nodules treated via microwave ablation, tumors measuring ≤ 3 cm demonstrated complete ablation upon imaging analysis conducted 1 month after surgery. Moreover, 5 of the tumors measuring > 3 cm demonstrated incomplete ablation. In these cases, a second procedure was performed, until imaging studies confirmed that complete ablation was achieved.ConclusionsLaparoscopic microwave ablation allows for precise puncture positioning, an effective ablation range, and safe and feasible surgery, which is especially suitable for liver tumors located in sites difficult to access.
“…Initial screening of abstracts led to the exclusion of 383 articles. Besides, six were further excluded by a close scrutiny of remaining articles: 1 35 only included OLR, 3 duplicates 24,36,37 , 1 38 did not report outcomes of interest and 1 39 used radiofrequency ablation. Finally, 32 non-randomized comparative studies were included in our meta-analysis 20,26,27,40–68 .Figure 1Study selection flow chart according to PRISMA statement.…”
The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary endpoints were oncological outcomes. In total, 32 eligible non-randomized studies with 4697 patients (LLR: 1809, OLR: 2888) were analyzed. There were higher rates of clear surgical margins (OR: 1.64, 95%CI: 1.32 to 2.05, p < 0.00001) in the LLR group, without significant differences in disease recurrence, 3- or 5-year overall survival(OS) and disease free survival(DFS) between the two approaches. LLR was associated with less intraoperative blood loss (WMD: −147.46 [−195.78 to −99.15] mL, P < 0.00001) and fewer blood transfusions (OR: 0.41 [0.30–0.58], P < 0.00001), but with longer operation time (WMD:14.44 [1.01 to 27.88] min, P < 0.00001) compared to OLR. Less overall morbidity (OR: 0.64 [0.55 to 0.75], p < 0.00001) and shorter postoperative hospital stay (WMD: −2.36 [−3.06 to −1.66] d, p < 0.00001) were observed for patients undergoing LLR, while there was no statistical difference in mortality. LLR appears to be a safe and feasible alternative to OLR in the treatment of CCLM in selected patients.
“…In recent years more and more studies support laparoscopy as an alternative to “open surgery” for liver resection for benign lesions as well as malignant tumours [ 17 ]. A laparoscopic approach for cystic echinococcosis has also been the subject of a number of studies [ 10 , 18 ].…”
IntroductionInfections caused by metacestode stage of the Echinococcus granulosus in humans result in disease named cystic echinococcosis.AimTo present the outcomes of patients treated surgically for cystic echinococcosis of the liver.Material and methodsOne hundred and nineteen patients treated in the period between 1989 and 2014 due to E. granulosus infection in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw were selected for this retrospective study. Diagnostic protocol included imaging examinations, i.e. ultrasonography and computed tomography of the abdomen. Blood samples where used to proceed sequential enzyme-linked immunosorbent assay (ELISA) using Em2plus antigen as well as polymerase chain reaction (PCR) to detect E. granulosus.ResultsSurgery was the choice for treatment for almost all of the patients (98.3%). In 40 (34.2%) patients right hemihepatectomy, in 19 (16.2%) patients left hemihepatectomy, and in 21 (17.9%) patients bisegementectomy were performed. Postoperative complications occurred in 4 (3.4%) patients. In 3 patients biliary fistula requiring endoscopic treatment was observed, and 1 patient had subdiaphragmatic abscess successfully treated with drainage under ultrasound guidance. None of the patients died in the postoperative period, and the 1-, 5-, and 10-year survival rates were 100.0%, 90.9%, and 87.9%, respectively.ConclusionsSurgical treatment of the symptomatic cystic echinococcosis is the modality of choice for E. granulosus infection of the liver. Despite substantial development of diagnostic methods and new management opportunities, echinococcal infection still presents a challenge for epidemiologists, pharmacologists, and clinicists.
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