A single centre experience of first "one hundred laparoscopic liver resections".

S Rehman, S K P John, J J French, D M Manas, S A White
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引用次数: 5

Abstract

Background. Laparoscopic liver resection (LLR) has emerged as an alternative procedure to open liver resection in selected patients. The purpose of this study was to describe our initial experience of 100 patients undergoing LLR. Methods. We analysed a prospectively maintained hepatobiliary database of 100 patients who underwent LLR between August 2007 and August 2012. Clinicopathological data were reviewed to evaluate surgical outcomes following LLR. Results. The median age was 64 and median BMI 27. Patients had a liver resection for either malignant lesions (n = 74) or benign lesions (n = 26). Commonly performed procedures were segmentectomy/metastectomy (n = 55), left lateral sectionectomy (LLS) (n = 26), or major hepatectomy (n = 19). Complete LLR was performed in 84 patients, 9 were converted to open and 7 hand-assisted. The most common indications were CRLM (n = 62), followed by hepatic adenoma (n = 9) or hepatocellular carcinoma (n = 7). The median operating time was 240 minutes and median blood loss was 250 mL. Major postoperative complications occurred in 9 patients. The median length of stay (LOS) was 5 days. One patient died within 30 days of liver resection. Conclusions. LLR is a safe and oncologically feasible procedure with comparable short-term perioperative outcomes to the open approach. However, further studies are necessary to determine long-term oncological outcomes.

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第一次“一百次腹腔镜肝脏切除术”的单一中心经验。
背景。腹腔镜肝切除术(LLR)已成为一种替代手术开放肝切除术在选定的患者。本研究的目的是描述我们对100例LLR患者的初步经验。方法。我们分析了在2007年8月至2012年8月间进行LLR的100例患者的前瞻性肝胆数据库。回顾临床病理资料以评估LLR后的手术结果。结果。中位年龄为64岁,中位BMI为27。恶性病变(n = 74)或良性病变(n = 26)的患者均行肝脏切除术。常用的手术是肝段切除术/转移切除术(n = 55),左外侧切除术(LLS) (n = 26)或肝大部切除术(n = 19)。84例患者行完全LLR,其中9例转为开腹,7例转为手辅助。最常见的适应症是CRLM (n = 62),其次是肝腺瘤(n = 9)或肝细胞癌(n = 7)。中位手术时间为240分钟,中位出血量为250 mL。术后发生重大并发症9例。中位住院时间(LOS)为5天。1例患者在肝切除术后30天内死亡。结论。LLR是一种安全且肿瘤可行的手术,短期围手术期结果与开放入路相当。然而,需要进一步的研究来确定长期的肿瘤预后。
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