Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study

Tranchart, Hadrien; Giuro, Giuseppe Di; Laïnas, Panagiotis; Roudié, Jean; Agostini, Hélène; Franco, Dominique; Dagher, Ibrahim

doi:10.1007/s00464-009-0745-3

Cited by 228 publications

(190 citation statements)

References 31 publications

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“…The safety and feasibility of the laparoscopic approach and its short-term benefits for HCC patients with chronic liver dysfunction have been demonstrated by several series [21][22][23][24][25][26][27][28][29][30][31] . To date, several studies have investigated the major differences between laparoscopic hepatectomy and open hepatectomy (Tables 1 and 2) [32][33][34][35][36][37][38][39] . Favorable short-term results, including fewer incidences of ascites and liver failure, and shorter postoperative hospital stays, correlate with the laparoscopic procedure.…”

Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

“…Favorable short-term results, including fewer incidences of ascites and liver failure, and shorter postoperative hospital stays, correlate with the laparoscopic procedure. Tranchart et al [36] reported laparoscopic resection of HCC for selected patients resulted in better postoperative outcomes without long-and short-term oncologic consequences (42 each laparoscopic-and open-hepatectomy patients, with more than 96% Child-Pugh class A patients and mostly anatomical resection). Early postoperative recovery and discharge with less postoperative pain are usual advantages of laparoscopic surgery.…”

Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

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Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Morise¹,

Kawabe

Kawase

et al. 2013

WJH

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Pure laparoscopic hepatectomy is a less invasive procedure than conventional open hepatectomy for the resection of hepatic lesions. Increases in experiences with the technique, in combination with advances in technology, have promoted the popularity of pure laparoscopic hepatectomy. However, indications for usage and potential contraindications of the procedure remain unresolved. The characteristics and specific advantages of the procedure, especially for hepatocellular carcinoma (HCC) patients with chronic liver diseases, are reviewed and discussed in this paper. For cirrhotic patients with liver tumors, pure laparoscopic hepatectomy minimizes destruction of the collateral blood and lymphatic flow from laparotomy and mobilization, and mesenchymal injury from compression. Therefore, pure laparoscopic hepatectomy has the specific advantage of minimal postoperative ascites production that leads to lowering the risk of disturbance in water or electrolyte balance and hypoproteinemia. It minimizes complications that routinely trigger postoperative serious liver failure. Under adequate patient positioning and port arrangement, the partial resection of the liver in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated in pure laparoscopic surgery by providing good vision and manipulation in the small operative field. Furthermore, the features of reduced post-operative adhesion, good vision, and manipulation within the small area between the adhesions make this procedure safer in the context of repeat hepatectomy procedures. These improved features are especially advantageous for patients with liver cirrhosis and multicentric and/or metachronous HCCs. Key words: Laparoscopic hepatectomy; Hepatocellular carcinoma; Liver cirrhosis; Chronic liver disease; Liver Tumor; Liver resection; Repeat hepatectomy; Bridging therapy to transplantation; Ascites; Postoperative liver failure Core tip: For cirrhotic patients with liver tumor, pure laparoscopic hepatectomy minimizes destruction of the collateral blood/lymphatic flow from laparotomy and mobilization, and has advantage of minimal postoperative ascites. It restrains the complications, which trigger the postoperative liver failure. The partial resection in the area of subphrenic space, peri-inferior vena cava area or next to the attachment of retro-peritoneum is facilitated with good vision and manipulation in the small operative field. Furthermore, repeat pure laparoscopic hepatectomy for patients with multicentric/ metachronous hepatocellular carcinomas was feasible and safe with the advantages of less post-operative adhesion and good vision and manipulation between the adhesions.

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Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

Section: Laparoscopic Hepatectomy For Hcc Patients: An Overviewmentioning

confidence: 99%

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Morise¹,

Kawabe

Kawase

et al. 2013

WJH

View full text Add to dashboard Cite

show abstract

“…However, in selected patients who undergo surgery by experienced hands, one of the most important advantage of the laparoscopic approach is the potential improvement in terms of blood loss and transfusion rates [4][5][6][7][8][9][10][11]. This specific improvement of the laparoscopic approach in comparison to open surgery was particularly underlined by the experts at the Morioka consensus.…”

Section: Discussionmentioning

confidence: 99%

“…), bleeding control during laparoscopic liver resection (LLR) is a liverspecific improvement, which has been underlined by many experts [4][5][6][7][8][9][10][11]. Several studies aimed to elucidate the factors responsible for reduced blood loss during laparoscopic liver surgery.…”

Section: Introductionmentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

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Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

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“…During the parenchymal transection phase, central venous pressure is lowered to between 2 and 4 mmHg with the use of nitrates, nitrous oxide, and dieresis. Combined with the tamponade effect of pneumoperitoneum, this technique minimizes blood loss from venous parenchymal bleeding (Tranchart, H et al 2010). Concern has been raised over the possibility of carbon dioxide embolism during laparoscopic liver surgery; however, extensive use of CO2 as an intravenous contrast agent in interventional radiology procedures shows that these fears are probably overstated (Hawkins, IF & Caridi, JG 1998).…”

Section: Anesthesia and Intraoperative Carementioning

confidence: 99%

Laparoscopic Liver Resection

Robert¹,

Joseph²

2011

Updated Topics in Minimally Invasive Abdominal Surgery

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Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study

Abstract: Laparoscopic resection of HCC for selected patients gave a better postoperative outcome without oncologic consequences. Prospective trials are required to confirm these results.

Cited by 228 publications

References 31 publications

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Pure laparoscopic hepatectomy for hepatocellular carcinoma with chronic liver disease

Bleeding control during laparoscopic liver resection: a review of literature

Laparoscopic Liver Resection

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