Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection

Ding, Zigang; Huang, Yong; Liu, Lingpeng; Xu, Bangran; Xiong, Hu; Luo, Dong Hua; Huang, Mingwen

doi:10.1007/s00423-020-01928-6

Cited by 17 publications

(15 citation statements)

References 46 publications

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“…A total of twenty studies including patients who underwent LCL met our inclusion criteria [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Three studies were excluded from our systematic review because they were lacking critical patient and procedure information [ 14 , 30 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Dorovinis

Machairas

Kykalos

et al. 2021

JCM

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Resection of the caudate lobe of the liver is considered a highly challenging type of liver resection due to the region’s intimacy with critical vascular structures and deep anatomic location inside the abdominal cavity. Laparoscopic resection of the caudate lobe is considered one of the most challenging laparoscopic liver procedures. The objective of our systematic review was to evaluate the safety, technical feasibility and main outcomes of laparoscopic caudate lobectomy LCL. A systematic review of the literature was undertaken for studies published until September 2021. A total of 20 studies comprising 221 patients were included. Of these subjects, 36% were women, whereas the vast majority of resections (66%) were performed for malignant tumors. Tumor size varied significantly between 2 and 160 mm in the largest diameter. The mean operative time was 210 min (range 60–740 min), and estimated blood loss was 173.6 mL (range 50–3600 mL). The median hospital length of stay LOS was 6.5 days (range 2–15 days). Seven cases of conversion to open were reported. The vast majority of patients (93.7%) underwent complete resection (R0) of their tumors. Thirty-six out of 221 patients developed postoperative complications, with 5.8% of all patients developing a major complication (Clavien–Dindo classification ≥ III).No perioperative deaths were reported by the included studies. LCL seems to be a safe and feasible alternative to open caudate lobectomy OCL in selected patients when undertaken in high-volume centers by experienced surgeons.

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Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Dorovinis

Machairas

Kykalos

et al. 2021

JCM

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“…Although there were a large number of studies confirming that surgery and percutaneous ablation treatment could bring survival benefits to some patients with HCC in the caudate lobe (2,16,17,26), these treatment options remained difficult to achieve and had higher local recurrence rate owing to its deep location, adjacent major vessels and limited therapeutic margin (5,7,15,36,37). Our study demonstrated that in the real world, for some selected patients with good liver function and high tumor burden, TACE could have significant benefits of survival and disease control.…”

Section: Discussionmentioning

confidence: 99%

“…Radiofrequency therapy cannot be performed safely under certain circumstances, such as thermal injury of adjacent structure, heat sink effect (near major vessels), and limited tumor necrosis range (15). Although some radical treatments or combination treatments have favorable clinical benefits in several studies (16)(17)(18), the five-year recurrence rate of HCC is still high.…”

Section: Introductionmentioning

confidence: 99%

Superselective Transarterial Chemoembolization for Unresectable or “Ablation Unsuitable” Hepatocellular Carcinoma in the Caudate Lobe: A Real World, Single-Center Retrospective Study

et al. 2021

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ObjectivesTo analyze the clinical outcomes of Transarterial chemoembolization (TACE) for unresectable or “ablation unsuitable” hepatocellular carcinoma (HCC) in the caudate lobe (CL) found at initial presentation in clinical practice.MethodsFifty-eight patients with HCC-CL undergoing conventional TACE from January 2015 to January 2020 were enrolled in our medical center. Overall survival (OS), progression-free survival (PFS), tumor response rate and major complication rates were analyzed. Multivariate analyses for potential clinical and radiologic factors were performed by using the Cox proportional hazard model.ResultsThe median OS was 23 months (95%CI: 18.1-27.9), and the median PFS was 11 months (95%CI: 7.4-14.6). The 1-, 3-, and 5-years OS rates were 66.5%, 31.9% and 15.7%, respectively. The 0.5, 1-, and 3-years PFS rates were 60.3%, 44.5% and 6.3%, respectively. Objective response rate was 53.4% and disease control rate was 79.3%. The most serious complication was bile duct injury, with an incidence of 3.4%. Multivariable analysis revealed that total bilirubin, Barcelona Clinic Liver Cancer stage, nonselective chemoembolization and TACE session were four significant factors associated with OS.ConclusionsSuperselective TACE treatment might be associated with better survival benefits in unresectable or “ablation unsuitable” HCC in the CL without macroscopic vascular invasion (MVI) and adequate liver function, compared with the non-selective TACE group, and should be considered as an important reliable therapy for surgeons and interventional radiologists.

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“…Operative techniques and features LCL operative techniques and features have been described in multicentre cohort studies, case series and case reports (Table 5) [3][4][5][6][7][8][9][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. All the analysed cases have been carried out laparoscopically.…”

Section: Caudate Lobe Resection In Consensus Conferences Guidelines and DI Culty Score Systemsmentioning

confidence: 99%

“…Laparoscopic approach to caudate lobe resection LCL has been described in multicentre cohort studies, case series and case reports and our review reports a total of 193 patients (Table 3) [4][5][6][7][8][9][10][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

Section: Caudate Lobe Resection In Consensus Conferences Guidelines and DI Culty Score Systemsmentioning

confidence: 99%

Knowledge and Surgical Strategies for Successful Laparoscopic Caudate Lobectomy, a Comprehensive Literature Review

Anselmo¹,

Vinci²,

Siragusa³

et al. 2021

Preprint

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Laparoscopic approach in patients presenting caudate lobe lesions has always been considered prohibitive as technically demanding, so that the role of minimally invasive surgery for this posterior and deep location is still debated. Recently some studies presented cases of laparoscopic caudate lobectomy discussing how to manage technical challenges and providing excellent results. Innovative technologies for laparoscopic liver surgery are likely to improve the feasibility and reproducibility of laparoscopic liver resections in the near future especially for lesions located in the so called “difficult segments”.Still, laparoscopic caudate lobectomy remains unfamiliar to many surgeons and there are relatively few reports in the literature on this subject. For this reason, we conducted a comprehensive review of the literature to understand the safety and feasibility of LCL resections and discuss current and future perspectives.

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Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection

Cited by 17 publications

References 46 publications

Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Safety and Efficacy of Laparoscopic Caudate Lobectomy: A Systematic Review

Superselective Transarterial Chemoembolization for Unresectable or “Ablation Unsuitable” Hepatocellular Carcinoma in the Caudate Lobe: A Real World, Single-Center Retrospective Study

Knowledge and Surgical Strategies for Successful Laparoscopic Caudate Lobectomy, a Comprehensive Literature Review

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