The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology

Rocca, Aldo; Cipriani, Francesco; Belli, Giulio; Berti, Stefano; Boggi, Ugo; Bottino, Vincenzo; Cillo, U.; Cescon, Matteo; Cimino, Matteo; Corcione, Francesco; Carlis, Luciano De; Degiuli, Maurizio; Paolis, Paolo De; Rose, Agostino Maria De; D’Ugo, Domenico; Benedetto, Fabrizio Di; Elmore, Ugo; Ercolani, Giorgio; Ettorre, Giuseppe Maria; Ferrero, Alessandro; Filauro, Marco; Giuliante, Felice; Gruttadauria, Salvatore; Guglielmi, Alfredo; Izzo, Francesco; Jovine, Elio; Laurenzi, Andrea; Marchegiani, Francesco; Marini, Pierluigi; Massani, Marco; Mazzaferro, Vincenzo; Mineccia, Michela; Minni, Francesco; Muratore, Andrea; Nicosia, S; Pellicci, R; Rosati, Riccardo; Russolillo, Nadia; Spinelli, Antonino; Spolverato, Gaya; Torzilli, Guido; Vennarecci, Giovanni; Viganò, Luca; Vincenti, Leonardo; Delrio, Paolo; Calise, Fulvio; Aldrighetti, Luca

doi:10.1007/s13304-021-01100-9

Cited by 39 publications

(35 citation statements)

References 169 publications

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“…In our case, liver biopsy and histological examination played a key role in establishing VDBS, but it was not possible to recognize a specific cause of the disease. Due to the low incidence reported in the literature, a standardized treatment of VDBS has not been established; hence, this rare condition must be managed at a tertiary liver referral center [ 10 , 11 ]. In most cases, patients with VBDS respond to treatment of the underlying condition or to the simple withdrawal of the harming agent [ 8 , 9 , 12 , 13 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

Vanishing Bile Duct Syndrome in an Adult Patient: Case Report and Review of the Literature

Izzo

Gallo

Codacci-Pisanelli

et al. 2022

JCM

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Vanishing bile duct syndrome (VBDS) is a rare condition characterized by progressive loss, destruction, and disappearance of the intra-hepatic bile ducts, leading to cholestasis and ductopenia. The exact mechanism of development of VDBS has not been established yet. Diagnosis of VBDS mainly relies on clinical and disease related presentations, but liver biopsy is compulsory for diagnosis. Due to the low incidence reported in the literature, a standardized treatment of VDBS has not been established; hence, this rare condition must be managed at a tertiary liver referral center. Here, we report the management and treatment of VBDS of an 81-year-old woman without any history of exposure to antibiotics, neoplasms, etc.

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Section: Discussionmentioning

confidence: 99%

Vanishing Bile Duct Syndrome in an Adult Patient: Case Report and Review of the Literature

Izzo

Gallo

Codacci-Pisanelli

et al. 2022

JCM

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“…Several hemostatic devices, such as ones providing soft coagulation with a monopolar electrode, a monopolar floating ball (TissueLink; Salient Surgical Technologies, Inc., Portsmouth, NH, USA), a Coolinside device (Apeiron Medical, Valencia, Spain), and the bipolar forceps coagulation, have been used clinically in recent years [ 3 , 15 , 18 , 27 , 28 ]. Bipolar cautery also offers advantages in terms of reduced blood loss during hepatectomy and shortened operation time [ 29 , 30 ]. Each device has its own advantage; however, to date, there is no consensus on the ideal method for hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

et al. 2022

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Background Various hemostatic devices have been utilized to reduce blood loss during hepatectomy. Nonetheless, a comparison between monopolar and bipolar coagulation, particularly their usefulness or inferiority, has been poorly documented. The aim of this study is to reveal the characteristics of these hemostatic devices. Methods A total of 264 patients who underwent open hepatectomy at our institution from January 2009 to December 2018 were included. Monopolar and bipolar hemostatic devices were used in 160 (monopolar group) and 104 (bipolar group) cases, respectively. Operative outcomes and thermal damage to the resected specimens were compared between these groups using propensity score matching according to background factors. Multivariate logistic regression analysis was performed to identify predictive factors for postoperative complications. Results After propensity score matching, 73 patients per group were enrolled. The monopolar group had significantly lower total operative time (239 vs. 275 min; P = 0.013) and intraoperative blood loss (487 vs. 790 mL; P < 0.001). However, the incidence rates of ascites (27.4% vs. 8.2%; P = 0.002) and grade ≥ 3 intra-abdominal infection (12.3% vs. 2.7%; P = 0.028) were significantly higher in the monopolar group. Thermal damage to the resected specimens was significantly longer in the monopolar group (4.6 vs. 1.2 mm; P < 0.001). Use of monopolar hemostatic device was an independent risk factor for ascites (odds ratio, 5.626, 95% confidence interval 1.881–16.827; P = 0.002) and severe intra-abdominal infection (odds ratio, 5.905, 95% confidence interval 1.096–31.825; P = 0.039). Conclusions Although monopolar devices have an excellent hemostatic ability, they might damage the remnant liver. The use of monopolar devices can be one of the factors that increase the frequency of complications.

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“…Nowadays hepatic metastases represent one of the main indications for laparoscopy and, according to the recent Southampton Consensus Guidelines for laparoscopic liver surgery, laparoscopic liver resection has been confirmed as a valid alternative to open surgery, especially if performed by surgeons experienced in both advanced laparoscopic techniques and liver surgery ( 30 ). Recently Rocca et al ( 31 ), in a national consensus involving 26 centers, analyzed the boundaries of minimally invasive simultaneous resections for synchronous liver metastasis and primary CRC. Although the authors produced 33 recommendations the level of evidence remains very low.…”

Section: State-of-the-artmentioning

confidence: 99%

“…The placement of the trocars depends on the type of resection that will be performed ( Figures 2 , 3 ) ( 31 , 32 ) and the surgical steps are performed as described by other authors ( 33 , 34 ) ( Figure 4 ).…”

Section: Surgical Techniquementioning

confidence: 99%

One-Stage Total Laparoscopic Treatment for Colorectal Cancer With Synchronous Metastasis. Is It Safe and Feasible?

et al. 2021

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Liver is the main target organ for colorectal cancer (CRC) metastases. It is estimated that ~25% of CRC patients have synchronous metastases at diagnosis, and about 60% of CRC patients will develop metastases during the follow up. Although several teams have performed simultaneous laparoscopic resections (SLR) of liver and colorectal lesions, the feasibility and safety of this approach is still widely debated and few studies on this topic are present in the literature. The purpose of this literature review is to understand the state of the art of SLR and to clarify the potential benefits and limitations of this approach. Several studies have shown that SLR can be performed safely and with short-term outcomes similarly to the separated procedures. Simultaneous laparoscopic colorectal and hepatic resections combine the advantages of one stage surgery with those of laparoscopic surgery. Several reports compared the short-term outcomes of one stage laparoscopic resection with open resections and showed a similar or inferior amount of blood loss, a similar or lower complication rate, and a significant reduction of hospital stay for laparoscopic surgery respect to open surgery but much longer operating times for the laparoscopic technique. Few retrospective studies compared long term outcomes of laparoscopic one stage surgery with the outcomes of open one stage surgery and did not identify any differences about disease free survival and the overall survival. In conclusion, hepatic and colorectal SLR are a safe and effective approach characterized by less intraoperative blood loss, faster recovery of intestinal function, and shorter length of postoperative hospital stay. Moreover, laparoscopic approach is associated to lower rates of surgical complications without significant differences in the long-term outcomes compared to the open surgery.

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The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology

Cited by 39 publications

References 169 publications

Vanishing Bile Duct Syndrome in an Adult Patient: Case Report and Review of the Literature

Vanishing Bile Duct Syndrome in an Adult Patient: Case Report and Review of the Literature

Comparison of operative outcomes between monopolar and bipolar coagulation in hepatectomy: a propensity score-matched analysis in a single center

One-Stage Total Laparoscopic Treatment for Colorectal Cancer With Synchronous Metastasis. Is It Safe and Feasible?

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