Laparoscopic liver resection for lesions adjacent to major vasculature: feasibility, safety and oncological efficiency.
J Gastrointest Surg
; 19(4): 692-8, 2015 Apr.
Article
en En
| MEDLINE
| ID: mdl-25564324
ABSTRACT
BACKGROUND AND OBJECTIVES:
Laparoscopic liver resection for lesions adjacent to major vasculature can be challenging, and many would consider it a contraindication. Recently, however, laparoscopic liver surgeons have been pushing boundaries and approached some of these lesions laparoscopically. We assessed feasibility, safety and oncological efficiency of this laparoscopic approach for these lesions.METHODS:
This is a monocenter study (2003-2013) describing technique and outcomes of laparoscopic liver resection for lesions adjacent to major vasculature <2 cm from the portal vein (main trunk and first division), hepatic arteries or inferior vena cava.RESULTS:
Thirty-seven patients underwent laparoscopic liver resection (LLR) for a lesion adjacent to major vasculature. Twenty-four (65%) resections were for malignant disease and 92% R0 resections. Conversion occurred in three patients (8%). Mean operative time was 313 min (standard deviation (SD) ± 101) and intraoperative blood loss 400 ml (IQR 213-700). Clavien-Dindo complications > II occurred in two cases (5%), with no mortality. Lesions at <1 cm were larger (7.2 cm (2.7-14) vs. 3 cm (2.5-5), p = 0.03) and operation time was longer (344 ± 94 vs. 262 ± 92 min, p = 0.01) than lesions at 1-2 cm from major vasculature.CONCLUSIONS:
Lesions <2 cm from major hepatic vasculature do not represent an absolute contraindication for LLR when performed by experienced laparoscopic liver surgeons in selected patients.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Laparoscopía
/
Hepatectomía
/
Neoplasias Hepáticas
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Gastrointest Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2015
Tipo del documento:
Article