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01-11-2019 | Multimedia Article

Laparoscopic Repeat Hepatic Resection for the Management of Liver Tumors

Authors: Yoshihiro Inoue, Kensuke Fujii, Masatsugu Ishii, Syuji Kagota, Atsushi Tomioka, Hiroki Hamamoto, Wataru Osumi, Yusuke Tsuchimoto, Tetsuji Terasawa, Takeshi Ogura, Shinsuke Masubuchi, Masashi Yamamoto, Akira Imoto, Akira Asai, Koji Komeda, Shinya Fukunishi, Fumitoshi Hirokawa, Masahiro Goto, Keitaro Tanaka, Junji Okuda, Kazuhide Higuchi, Kazuhisa Uchiyama

Published in: Journal of Gastrointestinal Surgery | Issue 11/2019

Abstract

Background

Laparoscopic hepatic resection has been developed as a minimally invasive surgery; however, laparoscopic repeat minor hepatic resection (LRH) carries a higher risk of damage to other organs because of postoperative changes to and losses of anatomical landmarks. The current standard approach at many facilities has been to perform open repeat minor hepatic resection (ORH). This paper describes the surgical outcomes, procedure safety, and utility of ORH versus LRH, as well as the laparoscopic techniques used in LRH.

Methods

Between February 2010 and May 2018, the data of 142 patients who underwent LRH or ORH at a single institution were retrospectively reviewed. Surgical outcomes, procedure safety, and procedure utility data were analyzed.

Results

Forty-five patients underwent LHR and 97 patients underwent ORH. The conversion rate from LHR to OHR was 13.3%. After propensity score matching (PSM), the estimated blood loss was significantly lower in the LRH group than in the ORH group (50 mL vs. 350 mL; P < 0.001). The LRH group had an 8.1% complication rate, while the ORH group had a complication rate of 24.3% (P = 0.044). The postoperative length of stay was significantly shorter in the LHR group than in the OHR group (9 days vs. 11 days) (P = 0.024).

Conclusion

LRH can be performed safely using various surgical devices. More favorable results are achieved with LRH than with ORH in terms of surgical outcomes including intraoperative bleeding, postoperative complications, and postoperative lengths of stay.

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Title: Laparoscopic Repeat Hepatic Resection for the Management of Liver Tumors
Authors: Yoshihiro Inoue
Kensuke Fujii
Masatsugu Ishii
Syuji Kagota
Atsushi Tomioka
Hiroki Hamamoto
Wataru Osumi
Yusuke Tsuchimoto
Tetsuji Terasawa
Takeshi Ogura
Shinsuke Masubuchi
Masashi Yamamoto
Akira Imoto
Akira Asai
Koji Komeda
Shinya Fukunishi
Fumitoshi Hirokawa
Masahiro Goto
Keitaro Tanaka
Junji Okuda
Kazuhide Higuchi
Kazuhisa Uchiyama
Publication date: 01-11-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 11/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-019-04276-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic Repeat Hepatic Resection for the Management of Liver Tumors

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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