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Laparoscopic liver resection for lesions adjacent to major vasculature: feasibility, safety and oncological efficiency

Laparoscopic liver resection for lesions adjacent to major vasculature: feasibility, safety and oncological efficiency
Laparoscopic liver resection for lesions adjacent to major vasculature: feasibility, safety and oncological efficiency
Background and ObjectivesLaparoscopic 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.MethodsThis 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.ResultsThirty-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.ConclusionsLesions <2 cm from major hepatic vasculature do not represent an absolute contraindication for LLR when performed by experienced laparoscopic liver surgeons in selected patients.
1091-255X
692-698
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47
van der Poel, Marcel J.
2fb8ae5c-b373-4e6a-8e4b-8b934d578c4f
Samim, Morsal
654aa18e-dcd4-41d4-9d8b-14485f3f1ea7
Besselink, Marc G.H.
4c2d9780-7d9c-4571-8e0e-f8df543b14aa
Flowers, David
8824cf73-bae9-4f15-b5f0-2d6672bce397
Stedman, Brian
180a4644-f670-4da1-84db-9d5640e4ec1d
Pearce, Neil W.
6e450393-03db-472b-9231-1aa2e39b0565
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47
van der Poel, Marcel J.
2fb8ae5c-b373-4e6a-8e4b-8b934d578c4f
Samim, Morsal
654aa18e-dcd4-41d4-9d8b-14485f3f1ea7
Besselink, Marc G.H.
4c2d9780-7d9c-4571-8e0e-f8df543b14aa
Flowers, David
8824cf73-bae9-4f15-b5f0-2d6672bce397
Stedman, Brian
180a4644-f670-4da1-84db-9d5640e4ec1d
Pearce, Neil W.
6e450393-03db-472b-9231-1aa2e39b0565

Abu Hilal, Mohammad, van der Poel, Marcel J., Samim, Morsal, Besselink, Marc G.H., Flowers, David, Stedman, Brian and Pearce, Neil W. (2015) Laparoscopic liver resection for lesions adjacent to major vasculature: feasibility, safety and oncological efficiency. Journal of Gastrointestinal Surgery, 19 (4), 692-698. (doi:10.1007/s11605-014-2739-2). (PMID:25564324)

Record type: Article

Abstract

Background and ObjectivesLaparoscopic 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.MethodsThis 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.ResultsThirty-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.ConclusionsLesions <2 cm from major hepatic vasculature do not represent an absolute contraindication for LLR when performed by experienced laparoscopic liver surgeons in selected patients.

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e-pub ahead of print date: 7 January 2015
Published date: April 2015
Organisations: Cancer Sciences

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Local EPrints ID: 400322
URI: http://eprints.soton.ac.uk/id/eprint/400322
ISSN: 1091-255X
PURE UUID: 7239b96d-b06f-43f6-92b1-6da8abf6b9aa

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Date deposited: 14 Sep 2016 13:47
Last modified: 15 Jul 2019 20:07

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Contributors

Author: Mohammad Abu Hilal
Author: Marcel J. van der Poel
Author: Morsal Samim
Author: Marc G.H. Besselink
Author: David Flowers
Author: Brian Stedman
Author: Neil W. Pearce

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