Role of preoperative 3D rendering for minimally invasive parenchyma sparing liver resections

Montalti, Roberto; Rompianesi, Gianluca; Cassese, Gianluca; Pegoraro, Francesca; Giglio, Mariano Cesare; Simone, G.; Rashidian, Nikdokht; Venetucci, Pietro; Troisi, Roberto

doi:10.1016/j.hpb.2023.04.008

Cited by 7 publications

(1 citation statement)

References 54 publications

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“…The laparoscopic procedures have been described in detail elsewhere. [20][21][22] A parenchymal-sparing approach was used whenever technically feasible, usually by performing multiple wedge resections for small peripheral lesions and/or an anatomical liver resection for large centrally located nodules. The proximity of major vessels, with the subsequent risk of ischemia of the remnant liver or R1 resection was also an important factor to decide if a parenchymal-sparing approach was feasible.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Cassese,

Han,

Lee

et al. 2023

J Hepato Biliary Pancreat

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BackgroundThere is still little knowledge about the outcomes of laparoscopic liver resection (LLR) for multiple hepatocellular carcinomas (HCC). The aim of this study was to assess the short‐ and long‐ term outcomes of LLR versus open liver resection (OLR) for patients with multiple HCC within and beyond the Milan criteria, and in both BCLC‐A and ‐B stage.MethodsData regarding all consecutive patients undergoing liver resection for multiple HCC were retrospectively collected from Asian (South Korean) and European (Italian) referral HPB centers. The cases were propensity‐score matched for age, BMI, center, extent of the resection, postero‐superior location of the lesion, underlying liver condition, BCLB staging and the Milan criteria.ResultsA total of 203 patients were included in the study: 27% of patients had undergone hemi‐hepatectomy, 26.6% atypical resections, 20.6% sectionectomy and 16.2% segmentectomy. After PSM two cohorts of 57 patients were obtained, with no significant differences in all preoperative characteristics. The length of hospital stay was significantly lower after LLR (median 7 vs. 9 days, p < .01), with no statistically significant differences in estimated blood loss, operation time, transfusions, postoperative bile leak, ascites, severe complications and R1 resection rates. After a median follow‐up of 61 (±7) months, there were no significant differences between OLR and LLR in both median OS (69 vs. 59 months, p = .74, respectively) and median DFS (12 vs. 10 months, p = .48, respectively).ConclusionLLR for multiple HCC can be safe and effective in selected cases and is able to shorten median hospital stay without affecting perioperative and long‐term oncological outcomes.

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Section: Surgical Proceduresmentioning

confidence: 99%

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Cassese,

Han,

Lee

et al. 2023

J Hepato Biliary Pancreat

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Evolution of laparoscopic liver resection in the last two decades: lessons from 2000 cases at a referral Korean center

Cassese,

Han,

Yoon

et al. 2023

Surg Endosc

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Laparoscopic versus open liver resection for huge hepatocellular carcinoma (≥ than 10 cm): a retrospective analysis from a high-volume referral center

Cassese,

Han,

Lee

et al. 2024

Surg Endosc

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Background There is still poor evidence about the safety and feasibility of laparoscopic liver resection (LLR) for huge (> 10 cm) hepatocellular carcinomas (HCC). The aim of this study was to assess the short- and long-term outcomes of LLR versus open liver resection (OLR) for patients with huge HCC from real-life data from consecutive patients. Methods Data regarding all consecutive patients undergoing liver resection for huge HCC were retrospectively collected from a Korean referral HPB center. Primary outcomes were the postoperative results, while secondary outcomes were the oncologic survivals. Results Sixty-three patients were included in the study: 46 undergoing OLR and 17 LLR. Regarding postoperative outcomes, there were no statistically significant differences in estimated blood loss, operation time, transfusions, postoperative bile leak, ascites, severe complications, and R1 resection rates. After a median follow-up of 48.4 (95% CI 8.9–86.8) months, there were no statistically significant differences in 3 years OS (59.3 ± 8.7 months vs. 85.2 ± 9.8 months) and 5 years OS (31.1 ± 9 months vs. 73.1 ± 14.1 months), after OLR and LLR, respectively (p = 0.10). Similarly, there was not a statistically significant difference in both 3 years DFS (23.5% ± 8.1 months vs. 51.6 ± months) and 5 years DFS (15.7 ± 7.1 months vs. 38.7 ± 15.3 months), respectively (p = 0.13), despite a potential clinically significant difference. Conclusion LLR for huge HCC may be safe and effective in selected cases. Further studies with larger sample size and more appropriate design are needed to confirm these results. Graphical abstract

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Role of preoperative 3D rendering for minimally invasive parenchyma sparing liver resections

Cited by 7 publications

References 54 publications

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Laparoscopic versus open liver resection for multiple hepatocellular carcinoma within and beyond the Milan criteria: An Eastern‐Western propensity score–matched analysis

Evolution of laparoscopic liver resection in the last two decades: lessons from 2000 cases at a referral Korean center

Laparoscopic versus open liver resection for huge hepatocellular carcinoma (≥ than 10 cm): a retrospective analysis from a high-volume referral center

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