Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases

Bari, Hassaan; Thiyagarajan, Umasankar Mathuram; Brown, Rachel M.; Roberts, Keith; Chatzizacharias, N.; Marudanayagam, R.; Muiesan, Paolo; Isaac, J.; Mirza, Darius F.; Sutcliffe, Robert P.; Dasari, Bobby

doi:10.1016/j.hpb.2021.03.018

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…However, in order to achieve R0 resections very often technically challenging approaches are required. Alternatively, R1 resections-defined as those with clear macroscopic margins, but with evidence of microscopic positive margins (8) have been reported (9). In addition, advances in different systemic treatments have allowed for an expanded patient population with more advanced and complex disease to be offered aggressive surgical treatment (2).…”

Section: Introductionmentioning

confidence: 99%

Surgical approach to achieve R0 resections in primary and metastatic liver tumors: a literature review

Vargas¹,

Dar²,

Fernandes³

et al. 2023

J Gastrointest Oncol

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Background and Objective: Primary and metastatic liver tumors are a significant cause of mortality worldwide. Regardless of the etiology of the tumor, macro-and microscopically clear margins (R0) while preserving adequate function of the remaining organ are the main goals after liver resections. However, technically challenging procedures are required to achieve R0 resection. Currently, there is no consensus of which should be the ideal minimal safety margin for liver tumor resections, with contrasting reports in regards of safety, tumor recurrence and overall outcomes following R0. Therefore, we aim to review current worldwide surgical practices to achieve R0 resections for primary and metastatic liver tumors in challenging surgical techniques and their reported outcomes.Methods: PubMed database, Google Scholar, and OVID Medline were searched for peer-reviewed original articles related to surgical techniques performed to achieve R0 resections in the setting of primary and/or metastatic liver tumors. An up-to-date review of English-language articles published between 2015 to July 2022 was performed.

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Section: Introductionmentioning

confidence: 99%

Surgical approach to achieve R0 resections in primary and metastatic liver tumors: a literature review

Vargas¹,

Dar²,

Fernandes³

et al. 2023

J Gastrointest Oncol

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Letter to the editor regarding “Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases”

Zhang¹,

Zhang²,

Xu³

2023

HPB

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Outpatient and Ambulatory Extended Recovery Robotic Hepatectomy: Multinational Study of 307 Cases

Park,

Lafaro,

Hagendoorn

et al. 2024

Journal of the American College of Surgeons

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Background: For open minor hepatectomy, morbidity and recovery are dominated by the incision. The robotic approach may transform this “incision dominant procedure” into a safe outpatient procedure. Study Design: We audited outpatient (<2 midnights) robotic hepatectomies at six hepatobiliary centers in two nations to test the hypothesis that the robotic approach can be a safe and effective short-stay procedure. ERAS programs were active at all sites, and home digital monitoring was available at one of the institutions. Results: Three hundred and seven outpatient (26 same-day, 281 next-day discharge) robotic hepatectomies were identified (2013-2023). Most were minor hepatectomies (194 single-segments, 90 bi-segmentectomies, 14 three-segments, 8 four-segments). Thirty-nine (13%) were for benign histology, while 268 were for cancer (33 hepatocellular carcinoma, 27 biliary, 208 metastatic disease). Patient characteristics were - median age 60 (18-93), 55% male, and median BMI 26 (14-63). Thirty (10%) had cirrhosis. One-hundred-eighty-seven (61%) had previous abdominal surgery. Median operative time was 163 minutes (30-433), with a median blood loss of 50 cc (10-900). There were no deaths and six complications (2%): 2 wound infections, 1 failure to thrive, and 3 perihepatic abscesses. Re-admission was required in 5 patients (1.6%). Of the 268 malignancy cases, 25 (9%) were R1 resections. Of the 128 with superior segment resections (segments 7/8/4A/2/1), there were 12 positive margins (9%) and two readmissions for abscess. Conclusions: Outpatient robotic hepatectomies in well-selected cases are safe (0 mortality, 2% complication, 1.6% re-admission), including resections in the superior or posterior portions of the liver that are challenging with non-articulating laparoscopic instruments.

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Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases

Cited by 3 publications

References 23 publications

Surgical approach to achieve R0 resections in primary and metastatic liver tumors: a literature review

Surgical approach to achieve R0 resections in primary and metastatic liver tumors: a literature review

Letter to the editor regarding “Liver Resection and role of Extended Histology (LiREcH study) in patients with multifocal colorectal cancer liver metastases”

Outpatient and Ambulatory Extended Recovery Robotic Hepatectomy: Multinational Study of 307 Cases

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