Takeshi Gocho, MD, PhD, Yuichi Nakaseko, MD, Koichiro Haruki, MD, PhD, Yuki Takano, MD, Fumitake Suzuki, MD, Shinji Onda, MD, PhD, Michinori Matsumoto, MD, PhD, Taro Sakamoto, MD, Shigeki Wakiyama, MD, PhD, Takeyuki Misawa, MD, PhD, Yuichi Ishida, MD, PhD, Katsuhiko Yanaga, MD, PhD. Jikei University School of Medicine
Background and Objective: In this decade, laparoscopic techniques have been introduced and widely applied for liver resections because of the less invasiveness and magnified view. We introduced hand-assisted laparoscopic liver resection (LLR) for benign and malignant lesions in the liver since 2006 and introduced pure LLR thereafter. The aim of this study was to assess the feasibility and safety of LLR for the treatment of hepatic malignancies.
Patients and methods: We retrospectively reviewed the data of 55 patients who underwent LLR (partial resection or left lateral lobectomy) between July 2006 and August 2016 at Jikei University Hospital. Of those, 48 patients who underwent LLR for hepatic malignancies were included in this study (age 41 – 86 [median 66] years, M:F = 34 : 14). We divided such patients into two groups according to the periods (1st period; 2006 – 2013, 2nd period; 2014 – 2016) and evaluated the patient background, C-P grade, diagnosis (primary vs. met), previous liver resection (LR), total pure LLR (TPLLR), simultaneous colorectal cancer surgery (CRC op), operative factors, conversion rate (CR), complications (Clavien-Dindo grade III and IV) and length of postoperative hospital stay (HS).
Results: In two periods, age (years, median) (62 vs. 69, p = 0.110), sex (%, male) (75% vs. 69%, p = 0.714), operative time (min, median) (260 vs. 251.5, p = 0.545), intraoperative blood loss (g, median) (167.5 vs. 50, p = 0.477), and HS (days, median) (8 vs. 8, p = 0.545) were comparable. However, more C-P B patients (0 vs. 11%) and metastatic tumors (5% vs. 95%, p = 0.007) were treated in 2nd period. More TPLLR (67% vs. 94%, p = 0.012), lower CR (17% vs. 3%, p = 0.085), and more previous LR (0 vs. 14%) were noted in 2nd period. There was one (8.3%) complication in 1st period, as compared to none in 2nd period.
Conclusion: Although more complex procedures have recently been performed, LLR remains feasible and safe.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79698
Program Number: P451
Presentation Session: Poster (Non CME)
Presentation Type: Poster
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