Laparoscopic liver resection compared to open approach in patients with colorectal liver metastases improves further resectability: Oncological outcomes of a case-control matched-pairs analysis

Montalti, Roberto; Berardi, Giammauro; Laurent, Stéphanie; Sebastiani, Simone; Ferdinande, Liesbeth; Libbrecht, Louis; Smeets, Peter; Brescia, Antonio; Rogiers, Xavier; Hemptinne, Bernard de; Geboes, Karen; Troisi, Roberto

doi:10.1016/j.ejso.2014.01.005

Cited by 92 publications

(70 citation statements)

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“…Moreover, it seems that patients with LLR had a faster oral intake and required less intravenous narcotic use [66]. LLR achieved similar short-and long-term oncologic outcomes for HCC or colorectal liver metastases (CLM) [59,62,69]. Finally, some authors advocated the systematic use of LLR for left lateral resection in benign liver lesions and in living donors for pediatric liver living donor transplantation [70,71].…”

Section: Minimally Invasive Approachmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Minimally Invasive Approachmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…Magyarországon benignus májelváltozás miatt végzett laparoszkópos beavatkozásról már több munkacsoport is beszámolt [5,6] A nemzetközi összefoglaló és összehasonlító tanulmá-nyok száma meredeken emelkedik, randomizált, kontrollált tanulmányt azonban eddig még nem közöltek a témában, jelenleg várják több futó vizsgálat eredménye-it. A tanulmányok alapján a laparoszkópos reszekció eredményei nem rosszabbak a nyílt reszekciós eredmé-nyektől sem a primer, sem az áttéti májdaganatok eseté-ben [20][21][22][23][24][25][26][27][28]. A 2014. októberben, Japánban, Morioká-ban rendezett, immár második konszenzuskonferencia során több szempont alapján értékelték a laparoszkópos májreszekciók helyzetét [29].…”

Section: Megbeszélésunclassified

A máj VII-es szegmentumában igazolt áttéti daganat laparoszkópos reszekciója

et al. 2016

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A májsebészet technikája és eredményei folyamatosan fejlődnek az utóbbi években, amely fejlődés talán legintenzí-vebben a laparoszkópos májsebészet területén érezhető. Az eddig közölt összehasonlító vizsgálatok alapján a laparoszkópos műtétek eredményei nem maradnak el a nyílt műtétek eredményeitől. Bár a májreszekciók igen kis száza-lékát végzik laparoszkóposan, a minimálisan invazív reszekciós technikának egyértelműen helye van az onkológiai sebészet területén. A minor, a major, az anatómiai vagy éppen a többszakaszos májreszekciók is elvégezhetők laparoszkóposan, és a korábban általános ajánlás, amely szerint az elöl fekvő szegmentumokban javasolható a minimálisan invazív technika, jelenleg már túlhaladott. A szerzők egy 70 éves nőbeteg esetét mutatják be, akinél rectumdaganat komplex onkosebészeti kezelését követően a máj VII-es szegmentumában kialakult metasztázis miatt végeztek laparoszkópos májreszekciót. Az esetismertetéssel a szerzők arra kívánnak rávilágítani, hogy a hátsó szegmentumok malignus elváltozásai is biztonsággal megközelíthetők és eltávolíthatók laparoszkóppal. Orv. Hetil., 2016, 157(20), 796-800. Kulcsszavak: májreszekció, laparoszkópia, onkológiai sebészet Laparoscopic resection of a liver metastasis from segment VII Case reportThe technique and clinical results of liver surgery are constantly evolving in recent years, and this development felt most intensely in the field of laparoscopic liver surgery. Based on the results of comparative studies reported to date, laparoscopic surgery is not inferior to open surgery. Although a very small percentage of liver resections are performed with laparoscopic technique, clearly it has a role in oncological surgery. The minor, major, anatomical, or even multi-stage liver resections can be performed with laparoscopy. The previously general recommendation, that lesions in the front segments of the liver are recommended for the minimally invasive technique is currently outdated. The authors present the history of a 70-year-old female, who underwent complex oncosurgical treatment of a locally advanced rectum carcinoma and a pure laparoscopic resection of a solitary hepatic metastasis of segment VII. With this case report the authors want to underline that malignant lesions in the posterior segments of the liver can be removed safely with laparoscopy. Keywords: liver resection, laparoscopy, surgical oncologyDede, K., Papp, G., Salamon, F., Uhlyarik, A., Bursics, A. [Laparoscopic resection of a liver metastasis from segment VII. Case report]. Orv. Hetil., 2016, 157(20), 796-800. Rövidítések ALPPS = (associating liver partition and portal pein ligation for staged hepatectomy) a májfelosztás és a májkapuvéna-lekötés összekapcsolása a szakaszos májeltávolításban; HALS = (handassisted laparoscopic surgery) kézzel asszisztált laparoszkópos sebészet A laparoszkópos sebészet kezdeti időszakából, az 1990-es évekből is vannak már irodalmi hivatkozások a máj minimálisan invazív reszekciójáról, mégis az utóbbi évti-zedben kezdődött a laparoszkópia térnyerése a májse...

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“…Kanazawa et al [20] ( Shelat et al [23] ( Isetani et al [22] ( Data are expressed as median (range) or mean ± standard deviation, unless stated otherwise. *In the paper by Belli et al, [13] operating time, bleeding and POHS are described separately for patients whose previous hepatectomy was open (upper) or laparoscopic (lower).…”

Section: Ethics Approvalmentioning

confidence: 99%

“…Here we present a case report of a fourth LLR for recurrent HCCs in cirrhotic liver and review the previously reported cases of repeat LLR for the treatment of HCC. [22,23] …”

Section: Introductionmentioning

confidence: 99%

Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

Morise¹,

Isetani²,

Kawabe³

et al. 2016

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A 73-year-old woman with liver cirrhosis caused by hepatitis C virus (HCV) underwent treatment of three hepatocellular carcinomas (HCCs) in liver segment 4, following three previous laparoscopic liver resections (LLRs) over 73 months. Contrast-enhanced computed tomography showed three 0.5-1.2 cm HCCs deep within the portal territories of subsegments 4a and 4b. The patient underwent laparoscopic resection of 4a and 4b, with the preservation of the portal branch to 4c, after minimal adhesiolysis around segment 4. The operation lasted 284 min, there was 50 mL of intra-operative bleeding and her recovery was uneventful. She was well, had experienced no recurrence and was HCV-negative, after taking oral anti-HCV therapy, 21 months later. LLR is associated with fewer adhesions after surgery and requires less adhesiolysis, because the laparoscope and forceps can be used in the small spaces between adhesions. The present patient underwent four LLRs over 6 years without severe deterioration of liver functional reserve. LLR is a useful localized therapy, which can be performed repeatedly and may prolong the survival of patients with multicentric metachronous HCCs. Key words:Laparoscopic liver resection, repeat liver resection, hepatocellular carcinoma, liver cirrhosis, anatomical liver resection, subsegmentectomy ABSTRACT Article history:

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Laparoscopic liver resection compared to open approach in patients with colorectal liver metastases improves further resectability: Oncological outcomes of a case-control matched-pairs analysis

Cited by 92 publications

References 44 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

A máj VII-es szegmentumában igazolt áttéti daganat laparoszkópos reszekciója

Case report of the fourth laparoscopic liver resection and review of repeat laparoscopic resection for recurrent hepatocellular carcinoma in cirrhotic liver

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