Yosuke Ueno, MD, Masayasu Aikawa, MD, Kenichiro Takase, MD, Katsuya Okada, MD, Kojun Okamoto, MD, Hiroshi Sato, MD, Shinichi Sakuramoto, MD, Shigeki Yamaguchi, MD, Yukihiro Watanabe, MD, Isaum Koyama, MD. Saitama Medical University, International Medical Center
Background: Laparoscopic liver resection (LLR) is increasingly performed and its feasibility has been established in a variety of situations. However, LLR for patients with a history of abdominal surgery is often avoided because of difficulty placing trocars.The aim of this study was to assess the feasibility and safety of concurrent laparoscopic liver resection and stoma closure (SC) in comparison with an open approach.
Method: Between April 2008 and September 2017, 4 patients who underwent concurrent LLR and SC (LLR group) were compared with 6 patients who underwent concurrent open liver resection and SC (OLR group). Patient background, characteristics, and perioperative outcomes were compared. In the LLR group, the first port was placed with an Alexis® wound retractor (Applied Medical, USA) and Free Access® (TOP Corporation, Japan) at the abdominal defect made by previous SC. An additional 2 or 3 trocars were placed as needed.
Results: All patients in the LLR group were treated using the laparoscopic approach. There were no other significant differences in patient background and characteristics.Operative duration was similar for these groups. Blood loss, complication rate, and hospital stay in the LLR group were significantly decreased compared with the OLR group.Conclusion: In concurrent liver resection and SC, the open approach may require multiple large incisions, but the laparoscopic approach can complete procedures with a stoma wound and a few port wounds. Additionally, use of a platform on the wound for SC enhances safety and efficacy for dissection of intraabdominal adhesions and a clear operative view.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86953
Program Number: P517
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster