Laparoscopic liver resection: indications, limitations, and economic aspects

Schmelzle, Moritz; Krenzien, Felix; Schöning, Wenzel; Pratschke, Johann

doi:10.1007/s00423-020-01918-8

Cited by 57 publications

(37 citation statements)

References 91 publications

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“…Further studies may also verify this for a diaphragmatic hernia after a liver resection. Finally, advances in laparoscopic and robotic surgery will show in the future whether the incidence of DH after liver resection will change or can also be reduced by, for example, a more detailed dissection [ 17 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections

Raakow

Megas

Schmelzle

et al. 2021

JCM

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Diaphragmatic hernia (DH) after a liver resection (LR) is an uncommon but potentially severe complication. In this retrospective study, we aim to share our experience with DH in our hepatic surgery center. We retrospectively analyzed 3107 patients who underwent a liver resection between January 2012 and September 2019. The diagnosis of DH was based on clinical examination and radiological imaging and confirmed by intraoperative findings during surgical repair. Five out of 3107 (0.16%) patients after LR developed DH. Especially, all five DH patients had a major right-sided LR before (n = 716, 0.7%). The mean time interval between initial LR and occurrence of DH was 30 months (range 15 to 44 months). DH exclusively occurred after a right or extended right hepatectomy. Two patients underwent emergency surgery, three were asymptomatic, and DH was diagnosed in follow-up imaging. Three of these five treated patients (60%) developed DH recurrence: two of three (67%) patients after suture repair alone and the only patient after suture repair in combination with an absorbable mesh. The patient who was treated with a composite mesh implant did not show any signs of DH recurrence after 52 months of follow-up. In patients who develop DH after liver surgery, a mesh augmentation with nonresorbable material is generally recommended. In order to diagnose these patients in an early state, we recommend that special attention be paid and a prompt and targeted diagnostic examination of patients with abdominal complaints after right-sided liver resections take place.

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Section: Discussionmentioning

confidence: 99%

Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections

Raakow

Megas

Schmelzle

et al. 2021

JCM

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“…LLR or OLR has no effect on the survival time of patients after surgery. LLR has advantages in terms of reducing operating time, length of hospital stays, and postoperative complications [11][12][13][14]. LLR is recommended if there is no special requirement and the surgical indication is suitable.…”

Section: Discussionmentioning

confidence: 99%

The influencing factors and survival rate of pulmonary metastasis after liver resection :a retrospective cohort study

Dai

2020

Preprint

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Background: Pulmonary metastasis(PM) form hepatocellular carcinoma(HCC) is a major indicator of a poor prognosis after liver resection. The study aimed to probe into the influencing factors for PM following open liver resection(OLR) and laparoscopic liver resection(LLR) with HCC. Method: All patients who suffered from LLR and OLR for primary HCC, who developed pulmonary metastasis, as first extrahepatic metastasis, were retrospectively analyzed in our department from January 2014 to August 2020. Results: Thirty-three cases were included (median age 50 years,81.8% male). The patients with a single tumor had 23 cases (69.7%), and a total of 10 patients(30.3%) has two and more tumors. 21 cases (63.6%) were smaller than 10 cm of tumor diameter. The median of operation time was 200 minutes (110-360), Portal vein occlusion occurred in 12 patients(36.4%). Patients with intrahepatic recurrence received vertebroplasty combined chemotherapy(VPCC), targeted therapy , trans-arterial chemo-embolization(TACE) and radio frequency catheter ablation(RFCA) in 1(3%),1(3%),10(30.3%) and 7(12.1%) cases respectively. The 2-and 3-year cumulative probability of overall survival (OS) were 63% and 41%. The median OS was 30.8 months. The median recurrence time was 6 months(1.7-4.8). The median of confirmed PM time from HCC was 12.5 months(1.5-61.1) and 17(51.5%) patients died. Conclusion: Early detection of intrahepatic recurrence and treatment can prolong PM time and overall survival time.

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“…Surgical procedures were performed as previously described [ 20 , 21 , 22 , 23 ]. At the beginning of every procedure, following laparotomy or laparoscopy, the peritoneal cavity was examined to rule out any previously undiagnosed tumor spread.…”

Section: Methodsmentioning

confidence: 99%

Minimal-Invasive Versus Open Hepatectomy for Colorectal Liver Metastases: Bicentric Analysis of Postoperative Outcomes and Long-Term Survival Using Propensity Score Matching Analysis

Knitter

Ανδρέου

Kradolfer

et al. 2020

JCM

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Minimal-invasive hepatectomy (MIH) has been increasingly performed for benign and malignant liver lesions with most promising short-term results. However, the oncological role of MIH in the treatment of patients with colorectal liver metastases (CRLM) needs further investigation. Clinicopathological data of patients who underwent liver resection for CRLM between 2012 and 2017 at the Department of Surgery, Charité-Universitätsmedizin Berlin, and the Inselspital Bern were assessed. Postoperative outcomes und long-term survivals of patients following MIH were compared with those after conventional open hepatectomy (OH) after 1:1 propensity score matching. During the study period, 229 and 91 patients underwent liver resection for CRLM at the Charité Berlin and the Inselspital Bern, respectively. Patients who underwent MIH in one of the two centers (n = 69) were compared with a matched cohort of patients who underwent OH. MIH was associated with lower complication rates (23% vs. 44%, p = 0.011), shorter length of intensive care unit stay (ICU, 1 vs. 2 days, p = 0.043), shorter length of hospital stay (7 vs. 11 days, p < 0.0001), and a reduced need for intraoperative transfusions (12% vs. 25%, p = 0.047) compared to OH. R0 status was achieved in 93% and 75% of patients after MIH and OH, respectively (p = 0.005). After a median follow-up of 31 months, MIH resulted in similar five-year overall survival (OS) rate (56% vs. 48%, p = 0.116) in comparison to OH. MIH for CRLM is associated with lower postoperative morbidity, shorter length of ICU and hospital stay, reduced need for transfusions, and comparable oncologic outcomes compared to the established OH. Our findings suggest that MIH should be considered as the preferred method for the treatment of curatively resectable CRLM.

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Laparoscopic liver resection: indications, limitations, and economic aspects

Cited by 57 publications

References 91 publications

Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections

Incidence, Diagnosis and Repair of a Diaphragmatic Hernia Following Hepatic Surgery: A Single Center Analysis of 3107 Consecutive Liver Resections

The influencing factors and survival rate of pulmonary metastasis after liver resection :a retrospective cohort study

Minimal-Invasive Versus Open Hepatectomy for Colorectal Liver Metastases: Bicentric Analysis of Postoperative Outcomes and Long-Term Survival Using Propensity Score Matching Analysis

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