Pure laparoscopic liver resection for large malignant tumors: does size matter?
Pure laparoscopic liver resection for large malignant tumors: does size matter?
Background
Laparoscopic liver resection (LLR) for large malignant tumors can be technically challenging. Data on this topic are scarce, and many question its feasibility, safety, and oncologic efficiency. This study aimed to assess outcomes of LLR for large (≥5 cm) and giant (≥10 cm) malignant liver tumors.
Methods
A prospectively collected database of 422 LLRs was reviewed from August 2003 to August 2013. The data for 52 patients undergoing LLR for large malignant tumors were analyzed. A subgroup analysis of giant tumors also is reported.
Results
During the period studied, 52 LLRs were performed (males, 53.8 %; mean age, 64.6 years) for large malignant tumors. Colorectal liver metastasis was the most common indication (42.3 %). The 52 LLRs included 32 major (61.5 %) and 20 minor (38.5 %) LLRs for tumors with a mean diameter of 83 mm. The median operative time was 240 min [interquartile range (IQR), 150–330 min], and the blood loss was 500 ml (IQR, 200–1,373 ml). Eight conversions (15.4 %) were performed. Six patients experienced complications (11.5 %). Among the 44 patients with successful LLRs, two patients (4.5 %) had an R1 resection. The median hospital stay was 5 days (range, 1–21 days), and no mortality occurred during a 90-day period. A subgroup analysis of patients with giant tumors showed greater blood loss (p = 0.002) and a longer operative time (p = 0.052) but no difference in terms of conversions (p = 0.64) or complications (p = 0.32).
Conclusion
The findings showed that LLR is feasible and safe for large malignant tumors and can be performed with acceptable morbidity and oncologic efficiency. When used for giant malignant tumors, LLR is associated with greater blood loss and a longer operative time but no increase in complications.
1288-1293
Shelat, Vishal G.
604ce3b0-83db-4358-80fb-b47fc48cfe6a
Cipriani, Federica
aca25573-d300-425d-ba9c-20be3190ce2e
Basseres, Tiago
ef333d2d-9e49-4f8c-9c7b-257c7e3e0045
Armstrong, Thomas H.
1bfc06e5-e83b-4090-acd3-2bcfa9885524
Takhar, Arjun S.
dbf44f14-c50a-4613-9843-49f0dd0b236b
Pearce, Neil W.
6e450393-03db-472b-9231-1aa2e39b0565
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47
April 2015
Shelat, Vishal G.
604ce3b0-83db-4358-80fb-b47fc48cfe6a
Cipriani, Federica
aca25573-d300-425d-ba9c-20be3190ce2e
Basseres, Tiago
ef333d2d-9e49-4f8c-9c7b-257c7e3e0045
Armstrong, Thomas H.
1bfc06e5-e83b-4090-acd3-2bcfa9885524
Takhar, Arjun S.
dbf44f14-c50a-4613-9843-49f0dd0b236b
Pearce, Neil W.
6e450393-03db-472b-9231-1aa2e39b0565
Abu Hilal, Mohammad
384e1c60-8519-4eed-8e92-91775aad4c47
Shelat, Vishal G., Cipriani, Federica, Basseres, Tiago, Armstrong, Thomas H., Takhar, Arjun S., Pearce, Neil W. and Abu Hilal, Mohammad
(2015)
Pure laparoscopic liver resection for large malignant tumors: does size matter?
Annals of surgical oncology, 22 (4), .
(doi:10.1245/s10434-014-4107-6).
(PMID:25256130)
Abstract
Background
Laparoscopic liver resection (LLR) for large malignant tumors can be technically challenging. Data on this topic are scarce, and many question its feasibility, safety, and oncologic efficiency. This study aimed to assess outcomes of LLR for large (≥5 cm) and giant (≥10 cm) malignant liver tumors.
Methods
A prospectively collected database of 422 LLRs was reviewed from August 2003 to August 2013. The data for 52 patients undergoing LLR for large malignant tumors were analyzed. A subgroup analysis of giant tumors also is reported.
Results
During the period studied, 52 LLRs were performed (males, 53.8 %; mean age, 64.6 years) for large malignant tumors. Colorectal liver metastasis was the most common indication (42.3 %). The 52 LLRs included 32 major (61.5 %) and 20 minor (38.5 %) LLRs for tumors with a mean diameter of 83 mm. The median operative time was 240 min [interquartile range (IQR), 150–330 min], and the blood loss was 500 ml (IQR, 200–1,373 ml). Eight conversions (15.4 %) were performed. Six patients experienced complications (11.5 %). Among the 44 patients with successful LLRs, two patients (4.5 %) had an R1 resection. The median hospital stay was 5 days (range, 1–21 days), and no mortality occurred during a 90-day period. A subgroup analysis of patients with giant tumors showed greater blood loss (p = 0.002) and a longer operative time (p = 0.052) but no difference in terms of conversions (p = 0.64) or complications (p = 0.32).
Conclusion
The findings showed that LLR is feasible and safe for large malignant tumors and can be performed with acceptable morbidity and oncologic efficiency. When used for giant malignant tumors, LLR is associated with greater blood loss and a longer operative time but no increase in complications.
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More information
Accepted/In Press date: 29 September 2014
Published date: April 2015
Organisations:
Cancer Sciences
Identifiers
Local EPrints ID: 400323
URI: http://eprints.soton.ac.uk/id/eprint/400323
ISSN: 1068-9265
PURE UUID: 97c0c6d9-05ce-46ff-93f9-49bd9d1304c1
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Date deposited: 14 Sep 2016 13:50
Last modified: 15 Mar 2024 02:14
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Contributors
Author:
Vishal G. Shelat
Author:
Federica Cipriani
Author:
Tiago Basseres
Author:
Thomas H. Armstrong
Author:
Arjun S. Takhar
Author:
Neil W. Pearce
Author:
Mohammad Abu Hilal
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