Laparoscopic Liver Resection for Peripheral Hepatocellular Carcinoma in Patients With Chronic Liver Disease

Cherqui, Daniel; Laurent, Alexis; Tayar, Claude; Chang, Sheng; Nhieu, Jeanne Tran Van; Loriau, J.; Karoui, Mehdi; Duvoux, Christophe; Dhumeaux, Daniel; Fagniez, Pierre-Louis

doi:10.1097/01.sla.0000206017.29651.99

Cited by 288 publications

(225 citation statements)

References 34 publications

(30 reference statements)

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“…Therapeutic options for HCC include liver transplantation, resection and local ablative techniques, such as radiofrequency ablation and alcohol injection. Liver resection is considered an efficient treatment for patients with preserved liver function, but, in the context of chronic liver disease, surgical outcome can be affected by significant morbidity due in part to laparotomy itself [1].…”

Section: Introductionmentioning

confidence: 99%

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Aldrighetti

Guzzetti

Pulitanò

et al. 2010

Journal of Surgical Oncology

134

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Background and Objectives: Laparoscopy is gaining acceptance as a safe procedure for resection of liver neoplasms. The aim of this study is to evaluate surgical results and mid-term survival of minor hepatic resection performed for HCC. Methods: Data of 16 patients with HCC, undergoing laparoscopic hepatectomy from September 2005 to January 2009, were compared to a control group of 16 patients who underwent open resection (OR) during the same period. The two groups were matched in terms of type of resection, tumor size, and severity of cirrhosis. Results: One patient underwent conversion to an open approach. Laparoscopic approach resulted in shorter operating time (150 min, P:0.044) and lower blood loss (258 ml, P:0.008). There was no difference in perioperative morbidity and mortality rate; laparoscopic approach was associated with a shorter hospital stay (6.3 days, P:0.039). After a mean follow up of 32 months, disease free survival and overall survival were 40.2 and 23.3 months for laparoscopic group, and 47.7 and 31.4 months for OR group (P NS). Conclusion: Laparoscopic resection of HCC is feasible and safe in selected patients and can result in good surgical results, with similar outcomes in terms of overall and disease-free survival.

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Section: Introductionmentioning

confidence: 99%

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Aldrighetti

Guzzetti

Pulitanò

et al. 2010

Journal of Surgical Oncology

134

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“…A abordagem laparoscópica pode tornar viável a ressecção hepática em pacientes cirróticos com hipertensão portal, que não tolerariam este mesmo procedimento por via laparotômica (1) .…”

Section: Discussionunclassified

Ressecção hepática robótica. Relato de experiência pioneira na América Latina

Machado

Makdissi

Surjan

et al. 2009

Arq. Gastroenterol.

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RESUMO -Graças ao melhor conhecimento da anatomia segmentar do fígado e desenvolvimento de novas técnicas, houve aumento no número de indicações de hepatectomias. O desenvolvimento da cirurgia minimamente invasiva ocorreu paralelamente e o aumento da experiência, aliado ao desenvolvimento de novos instrumentais, resultaram no crescimento exponencial das ressecções hepáticas videolaparoscópicas. A abordagem laparoscópica pode tornar viável a ressecção hepática em pacientes cirróticos com hipertensão portal que não tolerariam este mesmo procedimento por via laparotômica. A cirurgia robótica surgiu nos últimos anos como a última fronteira de desenvolvimento técnico aplicado à videocirurgia. O presente trabalho descreve a experiência pioneira de ressecção hepática totalmente com o uso de robótica na América Latina, em paciente com carcinoma hepatocelular e cirrose hepática. A hepatectomia laparoscópica com o uso do sistema robótico Da Vinci permite refinamentos técnicos graças à visualização tridimensional do campo cirúrgico e utilização de instrumentais precisos e com grande amplitude de movimentação que simulam os movimentos da mão humana.

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“…The subsequent LT may be made more difficult. The use of laparoscopic or transthoracic approaches for peripheral tumors may further contribute to expand this strategy by minimizing technical difficulties during the transplant procedure [18,[28][29][30][31]. Initial laparoscopic liver resection seems beneficial in order to decrease preoperative difficulties as recently reported by Laurent et al In their series, 24 LTs were performed, 12 following laparoscopic liver resection (LLR) and 12 following prior open liver resection (OLR).…”

Section: Resection Prior To Transplantationmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma: current topics in France

Scatton

Liddo

Belghiti

2009

J Hepato Biliary Pancreat

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Background Excellent survival obtained with liver transplantation (LT) for limited hepatocellular carcinoma (HCC) in patients with chronic liver disease is still challenged by the increasing discrepancy between candidates and grafts available. We review the current strategy of LT for HCC in our country highlighting the tendency: (1) to expand recipient selection beyond the Milan criteria, (2) to use systematic pre-LT treatments with a greater number of resections and (3) new rules for graft attribution. Results Although the vast majority of cirrhotic patients with HCC are transplanted within the Milan criteria; the number of candidates is continually rising, while the number of grafts available is stable with a disappearance of adult LDLTs. Moreover, the new rules for organ allocations, mainly based on the MELD score, minimize the accessibility to liver grafts for patients with HCC and compensated liver disease. For these reasons, in France we have observed an increase in waiting time for HCC patients, leading to the extensive use of pre-LT treatments in order to limit the list dropouts. Many studies have been performed on transarterial chemo-embolization (TACE) and supraselective TACE. Moreover, the use of liver resection (LR) as a bridge therapy, showing that initial resection does not impair short-and long-term survival, led French surgeons to develop the concept of LR as a way to select patients who might benefit from LT and to use it, in selected cases, as a primary therapy, considering LT as salvage treatment in case of recurrence. Conclusions The number of HCC candidates who cannot benefit from a LT is increasing worldwide. The French answer to this situation involves pre-LT treatments, particularly partial LR, based mainly on the excellent Japanese results in this field. Moreover, the country of « égalité » is actually modifying the rules of graft attribution in order to reduce the inequality between the HCC patients with poor and good liver function.

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Laparoscopic Liver Resection for Peripheral Hepatocellular Carcinoma in Patients With Chronic Liver Disease

Cited by 288 publications

References 34 publications

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Case‐matched analysis of totally laparoscopic versus open liver resection for HCC: Short and middle term results

Ressecção hepática robótica. Relato de experiência pioneira na América Latina

Liver transplantation for hepatocellular carcinoma: current topics in France

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