Laparoscopic Resection for Liver Malignancies: Do the Elderly Benefit More?

Fretland, Åsmund Avdem; Kazaryan, Airazat M.; Edwin, Bjørn

doi:10.1080/08941939.2017.1385664

Cited by 2 publications

(2 citation statements)

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“…More elderly patients who were previously denied an opportunity for a potentially curative liver resection are now offered surgery. This is in line with recent reports showing that LLR might be beneficial in elderly patients [12,13].…”

Section: Discussionsupporting

confidence: 93%

“…Notably, the operation time continuously decreased which reflects that operative techniques are still in development. The longer operative time observed in the early period reflects the pioneering self-learning stage of laparoscopic liver surgery introduction in our institution (13). After a period of middle experience characterized by relatively narrow dispersion of operative time, a second, and less pronounced, increase of operative time dispersion was observed in the most recent period (Table 2; Fig.…”

Section: Discussionmentioning

confidence: 74%

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Evolution of laparoscopic liver surgery: 20-year experience of a Norwegian high-volume referral center

et al. 2021

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Background Laparoscopic liver surgery has evolved to become a standard surgical approach in many specialized centers worldwide. In this study we present the evolution of laparoscopic liver surgery at a single high-volume referral center since its introduction in 1998. Methods Patients who underwent laparoscopic liver resection (LLR) between August 1998 and December 2018 at the Oslo University Hospital were analyzed. Perioperative outcomes were compared between three time periods: early (1998 to 2004), middle (2005 to 2012) and recent (2013–2018). Results Up to December 2020, 1533 LLRs have been performed. A total of 1232 procedures were examined (early period, n = 62; middle period, n = 367 and recent period, n = 803). Colorectal liver metastasis was the main indication for surgery (68%). The rates of conversion to laparotomy and hand-assisted laparoscopy were 3.2% and 1.4%. The median operative time and blood loss were 130 min [interquartile range (IQR), 85–190] and 220 ml (IQR, 50–600), respectively. The total postoperative complications rate was 20.3% and the 30-day mortality was 0.3%. The median postoperative stay was two (IQR, 2–4) days. When comparing perioperative outcomes between the three time periods, shorter operation time (median, from 182 to 120 min, p < 0.001), less blood loss (median, from 550 to 200 ml, p = 0.023), decreased rate of conversions to laparotomy (from 8 to 3%) and shorter postoperative hospital stay (median, from 3 to 2 days, p < 0.001) was observed in the later periods, while the number of more complex liver resections had increased. Conclusion During the last two decades, the indications, the number of patients and the complexity of laparoscopic liver procedures have expanded significantly. Initially being an experimental approach, laparoscopic liver surgery is now safely implemented across our unit and has become the method of choice for surgical treatment of most liver tumors.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 74%