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. 2021 Apr 1;273(4):785-791.
doi: 10.1097/SLA.0000000000003575.

"VSports注册入口" Parenchymal Sparing Anatomical Liver Resections With Full Laparoscopic Approach: Description of Technique and Short-term Results

Giammauro Berardi  1 , Kazuharu Igarashi, Chao Jen Li, Takahiro Ozaki, Kohei Mishima, Kosuke Nakajima, Masayuki Honda, Go Wakabayashi
Affiliations

Parenchymal Sparing Anatomical Liver Resections With Full Laparoscopic Approach: Description of Technique and Short-term Results

"V体育平台登录" Giammauro Berardi et al. Ann Surg. .

Abstract

Objective: The aim of this study was to describe laparoscopic anatomical parenchymal sparing liver resections for hepatocellular carcinoma (HCC) and colorectal liver metastases (CRLM) and report the short-term outcomes. VSports手机版.

Background: Anatomical resections (ARs) have better oncological outcomes compared to partial resections in patients with HCC, and some suggest should be performed also for CRLM as micrometastasis occurs through the intrahepatic structures V体育安卓版. Furthermore, remnant liver ischemia after partial resections has been associated with worse oncological outcomes. Few experiences on laparoscopic anatomical resections have been reported and no data on limited AR exist. .

Methods: We performed a retrospective analysis of 86 patients undergoing full laparoscopic anatomical parenchymal sparing resections with preoperative surgical simulation and standardized procedures V体育ios版. .

Results: A total of 55 patients had HCC, whereas 31 had CRLM with a median of 1 lesion and a size of 30 mm. During preoperative three-dimensional (3D) simulation, a median resection volume of 120 mL was planned. Sixteen anatomical subsegmentectomies, 56 segmentectomies, and 14 sectionectomies were performed VSports最新版本. Concordance between preoperative 3D simulation and intraoperative resection was 98. 7%. Two patients were converted, and 7 patients experienced complications. Subsegmentectomies had comparable blood loss (166 mL, P = 0. 59), but longer operative time (426 min, P = 0. 01) than segmentectomies (blood loss 222 mL; operative time 355 min) and sectionectomies (blood loss 120 mL; operative time 295 min). R0 resection and margin width remained comparable among groups. .

Conclusions: A precise preoperative planning and a standardized surgical technique allow to pursue the oncological quality of AR enhancing the safety of the parenchyma sparing principle, reducing surgical stress through a laparoscopic approach V体育平台登录. .

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Conflict of interest statement

The authors report no conflicts of interest.

References

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    1. European Association for the Study of the Liver. Electronic address: easloffice@www.qiuluzeuv.cn, European Association for the Study of the Liver. EASL clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2018; 69:182–236.
    1. Billingsley KG, Jarnagin WR, Fong Y, et al. Segment-oriented hepatic resection in the management of malignant neoplasms of the liver. J Am Coll Surg 1998; 187:471–481.
    1. Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg 2005; 242:252–259.
    1. Margonis GA, Buettner S, Andreatos N, et al. Anatomical resections improve disease-free survival in patients with KRAS-mutated colorectal liver metastases. Ann Surg 2017; 266:641–649.

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