Laparoscopic hepatectomy for benign hepatic lesions: short and long-term outcomes including quality-of-life evaluation

Abstract

Aim: Even though laparoscopic hepatectomy (LH) has proved to be both safe and effective in specialized centers; the restricted indications for resection in the case of benign liver lesions has resulted in poorly reported outcomes. Our aim was to describe the short and long-term results of LH to treat benign hepatic lesions, including quality of life (QoL) evaluation. Methods: Thirty-one LHs were performed between 2007 and 2018 in 30 patients. We evaluated QoL with the SF-36 test and a body image satisfaction questionnaire by personal interview before surgical treatment and at 1 month, 3 months, 6 months and 1 year after surgery. Results: Median age was 38 years (range 21-71) and the majority were females (68%). The most frequent etiology was hepatic adenoma in 16 patients (52%), followed by focal nodular hyperplasia (n = 4), cavernous hemangioma (n = 3), hepatic abscess (n = 3), cystadenoma (n = 5) and hepatolithiasis (n = 1). The majority of resections were minor (66%) and the conversion rate was 6.2%. Pathological examination confirmed negative margins in all patients. Postoperative mortality was nil, while morbidity was 6.2%. Median hospital stay was 4 days (range 1-32 days). In a median follow-up of 48 months (range 2-120), 2 patients experienced recurrence. QoL variables were similar between the preoperative and postoperative periods. Conclusion: LH should be considered the main therapeutic approach for treating selected patients with benign liver lesions who require surgical resection because it presented both null mortality and low morbidity, along with rare recurrence, a good quality of life and high esthetic satisfaction.

Giant hepatic hemangioma case report: When is it time for surgery?

“…Our decision to perform a laparoscopic treatment was due to the easy anatomic accessibility (V segment, having a wide peduncle). As suggested by several Authors [ [16] , [17] , [18] , [19] , [20] ], laparoscopic surgery is indicated for both lesions with localization in the left hepatic portion and in the lower segments of right lobe. This technique saves more healthy tissue as possible – instead of right or left open hepatectomy.…”

Mini-laparotomy in emergency general surgery in a second-level hospital in Zambia: a prospective cohort study

“…Much of the literature presenting surgical approach techniques tends to oppose different methods of mini-invasive and standard incisions [4,11,13]. However, ML incision in fact represents a technical step in performing the laparoscopy-assisted procedure, which is considered a standard operation in current abdominal surgery at present [40,43].…”

New trends in minimally invasive management of liver tumors

“…The aim of this Special Issue was to portray in full range the state-of-the-art minimally invasive surgical techniques that form the up-to-date armamentarium to manage patients with liver tumors. This special issue would not have been produced without the outstanding contributions of experts from Brazil, Germany, Italy and India, who present their experience and discuss topics such as minimally-invasive liver resection for liver tumors both in adults and children, quality-of-life evaluation after laparoscopic liver resections, enhanced recovery after surgery in liver resections and endoscopic ultrasound-guided drainage of the biliary tree in malignant obstructions [5][6][7][8][9] . I want to express my gratitude to these authors for their time and effort in producing high-quality original manuscripts that demonstrate the many benefits of minimally invasive management of liver tumors and confirm that these approaches will certainly keep developing in the years to come for the good of our patients.…”