Total laparoscopic management of lesions involving liver segment 7
Total laparoscopic management of lesions involving liver segment 7
Background
Until recently, laparoscopic resection of tumors involving segment 7 (s7) of the liver was seen as a relative contraindication. We analyzed our experiences with laparoscopic resection of tumors in s7.
Methods
Retrospective analysis of prospective database on operative and postoperative characteristics and surgical outcomes of patients in whom the intention was to remove tumors located in s7 of the liver laparoscopically. We defined two groups: those with laparoscopic metastasectomy of s7 (s7 group) and those undergoing laparoscopic right posterior sectionectomy (RPS group).
Results
Of 400 patients undergoing laparoscopic liver resection, 20 patients (5 %) underwent total laparoscopic resections of tumors in s7 (7 metastasectomy of s7 and 13 RPS). The type of resection was decided on the basis of tumor size and location. Median age was 70 years (range 46–82), and the indication for surgery was mainly CRLM (n = 13, 65 %) and HCC (n = 4, 20 %). There was 1 (5 %) conversion. Mean operative times were 252 min (±69) for s7 and 271 min (±102) for RPS. The mean intraoperative blood loss was 400 mL (±493) for s7 and 625 mL (±363) for RPS. A Pringle maneuver was used in 86 % of patients in s7 group and 75 % of patients in RPS group. Mean total hospital stay was 4.6 days (±2.5) in s7 and 6.9 days (±7.8) for RPS. The overall R0 resection rate was 95 % (s7 100 %, RPS 92 %).
Conclusion
Although resection of lesions in s7 is technically demanding, a laparoscopic approach can be performed safely and effectively in experienced hands.
3190-3195
Coles, S.R.
f3b427a4-5e9d-4e65-8b2e-fcf5259eff6c
Besselink, M.G.
701b782f-4e07-4b9f-a75f-af28a6aa8cd9
Serin, K.R.
915ace8e-2c4d-4e38-872b-cddb003c8723
Alsaati, H
ea49c18a-cbe0-44e5-a550-7b8d2d292243
Di Gioia, P
93fcc2c8-c7a8-4d07-b1c5-6c71af6e41ed
Samim, M.
654aa18e-dcd4-41d4-9d8b-14485f3f1ea7
Pearce, N.W.
6134a6e9-897c-4607-b17b-a32bdf7a43c3
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
November 2015
Coles, S.R.
f3b427a4-5e9d-4e65-8b2e-fcf5259eff6c
Besselink, M.G.
701b782f-4e07-4b9f-a75f-af28a6aa8cd9
Serin, K.R.
915ace8e-2c4d-4e38-872b-cddb003c8723
Alsaati, H
ea49c18a-cbe0-44e5-a550-7b8d2d292243
Di Gioia, P
93fcc2c8-c7a8-4d07-b1c5-6c71af6e41ed
Samim, M.
654aa18e-dcd4-41d4-9d8b-14485f3f1ea7
Pearce, N.W.
6134a6e9-897c-4607-b17b-a32bdf7a43c3
Abu Hilal, M.
384e1c60-8519-4eed-8e92-91775aad4c47
Coles, S.R., Besselink, M.G., Serin, K.R., Alsaati, H, Di Gioia, P, Samim, M., Pearce, N.W. and Abu Hilal, M.
(2015)
Total laparoscopic management of lesions involving liver segment 7.
Surgical Endoscopy, 29 (11), .
(doi:10.1007/s00464-014-4052-2).
(PMID:25582963)
Abstract
Background
Until recently, laparoscopic resection of tumors involving segment 7 (s7) of the liver was seen as a relative contraindication. We analyzed our experiences with laparoscopic resection of tumors in s7.
Methods
Retrospective analysis of prospective database on operative and postoperative characteristics and surgical outcomes of patients in whom the intention was to remove tumors located in s7 of the liver laparoscopically. We defined two groups: those with laparoscopic metastasectomy of s7 (s7 group) and those undergoing laparoscopic right posterior sectionectomy (RPS group).
Results
Of 400 patients undergoing laparoscopic liver resection, 20 patients (5 %) underwent total laparoscopic resections of tumors in s7 (7 metastasectomy of s7 and 13 RPS). The type of resection was decided on the basis of tumor size and location. Median age was 70 years (range 46–82), and the indication for surgery was mainly CRLM (n = 13, 65 %) and HCC (n = 4, 20 %). There was 1 (5 %) conversion. Mean operative times were 252 min (±69) for s7 and 271 min (±102) for RPS. The mean intraoperative blood loss was 400 mL (±493) for s7 and 625 mL (±363) for RPS. A Pringle maneuver was used in 86 % of patients in s7 group and 75 % of patients in RPS group. Mean total hospital stay was 4.6 days (±2.5) in s7 and 6.9 days (±7.8) for RPS. The overall R0 resection rate was 95 % (s7 100 %, RPS 92 %).
Conclusion
Although resection of lesions in s7 is technically demanding, a laparoscopic approach can be performed safely and effectively in experienced hands.
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More information
e-pub ahead of print date: 13 January 2015
Published date: November 2015
Organisations:
Cancer Sciences
Identifiers
Local EPrints ID: 400321
URI: http://eprints.soton.ac.uk/id/eprint/400321
ISSN: 0930-2794
PURE UUID: 44755e9c-a63a-4105-97e8-e01e4546e11b
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Date deposited: 14 Sep 2016 13:45
Last modified: 15 Mar 2024 02:14
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Contributors
Author:
S.R. Coles
Author:
M.G. Besselink
Author:
K.R. Serin
Author:
H Alsaati
Author:
P Di Gioia
Author:
M. Samim
Author:
N.W. Pearce
Author:
M. Abu Hilal
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