Laparoscopic-Assisted Hepatectomy for Metastatic Liver Tumor.

Introduction: As laparoscopic surgery has come into more widespread use in recent years, especially for colorectal cancer, we consider that laparoscopic minimal invasive approach for metastatic liver tumors is one of the useful modalities as a multidisciplinary therapy for colorectal cancer. However the results of this technique are still not certain.
Aims & Methods: In this report, we evaluate the short term results of laparoscopic liver resection for metastatic liver tumor. We have performed laparoscopic surgery in 72 patients with hepatic tumors since Dec. 1997. In 72 patients, 15 laparoscopic liver resections were performed for metastatic liver tumors including one patient who underwent laparoscopic liver resection twice. Mortality, morbidity, recurrence and survival rates were analyzed.
Results: The tumor mean size was 3.5 } 2.1 cm (range 1.5 to 10.0 cm) and the tumor mean number was 2.1 } 2.3 (range 1 to 9). The patient mean age was 65.9 } 9.8 years old. There were 3 right lobectomies, 2 lateral segmentectomies, 1 spiegel lobectomy, 2 unisegmentectomies and 7 atypical resections. Operation time asavaraged 206 } 86 minutes, and the mean blood loss was 266 ml. There was no case requiring conversion to ordinary laparotomy, but we used hand-assisted methods in 5 cases and the mini-laparotomy combined method in 4 cases. The average hospital stay after operation was 16.6 } 6.5 days including chemotherapy. The adjuvant-chemotherapy, if necessary, could start relatively earlier than in patients who underwent ordinary open liver resection, but there are still no data comparing these two groups. No ascites but transient liver failure occurred in 1 patient who underwent right lobectomy. 6 (43%) patients had a recurrence within lung (2), liver (2), bone (1), and local peritoneum (1), and there was no port site recurrence.
Conclusion: Although the indications need to be strictly determined, laparoscopic liver resection for metastatic liver tumors is feasible.


Session: Poster

Program Number: P309

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