scholarly journals Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

2021 ◽  
Author(s):  
Andrea Ruzzenente ◽  
◽  
Andrea Ciangherotti ◽  
Luca Aldrighetti ◽  
Giuseppe Maria Ettorre ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Liver Metastases ◽  
Hospital Stay ◽  
Complication Rate ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Caudate Lobe ◽  
Open Group ◽  
Perioperative Outcomes ◽  
Minimally Invasive Liver Surgery

Abstract Background Although isolated caudate lobe (CL) liver resection is not a contraindication for minimally invasive liver surgery (MILS), feasibility and safety of the procedure are still poorly investigated. To address this gap, we evaluate data on the Italian prospective maintained database on laparoscopic liver surgery (IgoMILS) and compare outcomes between MILS and open group. Methods Perioperative data of patients with malignancies, as colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), non-colorectal liver metastases (NCRLM) and benign liver disease, were retrospectively analyzed. A propensity score matching (PSM) analysis was performed to balance the potential selection bias for MILS and open group. Results A total of 224 patients were included in the study, 47 and 177 patients underwent MILS and open isolated CL resection, respectively. The overall complication rate was comparable between the two groups; however, severe complication rate (Dindo–Clavien grade ≥ 3) was lower in the MILS group (0% versus 6.8%, P = ns). In-hospital mortality was 0% in both groups and mean hospital stay was significantly shorter in the MILS group (P = 0.01). After selection of 42 MILS and 43 open CL resections by PSM analysis, intraoperative and postoperative outcomes remained similar except for the hospital stay which was not significantly shorter in MILS group. Conclusions This multi-institutional cohort study shows that MILS CL resection is feasible and safe. The surgical procedure can be technically demanding compared to open resection, whereas good perioperative outcomes can be achieved in highly selected patients.

Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial

2019 ◽  
Vol 33 (12) ◽  
pp. 3926-3936 ◽  
Author(s):  
Ricardo Robles-Campos ◽  
Víctor Lopez-Lopez ◽  
Roberto Brusadin ◽  
Asunción Lopez-Conesa ◽  
Pedro José Gil-Vazquez ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Controlled Trial ◽  
Minimally Invasive Liver Surgery ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Open Versus

scholarly journals Robotic and laparoscopic liver surgery for colorectal liver metastases: an experience from a German Academic Center

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mirhasan Rahimli ◽  
Aristotelis Perrakis ◽  
Vera Schellerer ◽  
Andrew Gumbs ◽  
Eric Lorenz ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Minimally Invasive ◽  
Liver Surgery ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Long Term Outcomes ◽  
Short Term ◽  
Minimally Invasive Liver Surgery ◽  
Previous Abdominal Surgery

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

scholarly journals Comparison of perioperative outcomes following open versus minimally invasive transforaminal lumbar interbody fusion in obese patients

2013 ◽  
Vol 35 (2) ◽  
pp. E10 ◽  
Author(s):  
Darryl Lau ◽  
Adam Khan ◽  
Samuel W. Terman ◽  
Timothy Yee ◽  
Frank La Marca ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hospital Stay ◽  
Complication Rate ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Perioperative Outcomes ◽  
Obese Patients ◽  
Class Iii ◽  
Obesity Class ◽  
Class I Obesity ◽  
Open Versus

Object Minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) has proven to be effective in the treatment of spondylolisthesis and degenerative disc disease (DDD). Compared with the traditional open TLIF, the MI procedure has been associated with less blood loss, less postoperative pain, and a shorter hospital stay. However, it is uncertain whether the advantages of an MI TLIF also apply specifically to obese patients. This study was dedicated to evaluating whether obese patients reap the perioperative benefits similar to those seen in patients with normal body mass index (BMI) when undergoing MI TLIF. Methods Obese patients—that is, those with a BMI of at least 30 kg/m2—who had undergone single-level TLIF were retrospectively identified and categorized according to BMI: Class I obesity, BMI 30.0–34.9 kg/m2; Class II obesity, BMI 35.0–39.9 kg/m2; or Class III obesity, BMI ≥ 40.0 kg/m2. In each obesity class, patients were stratified by TLIF approach, that is, open versus MI. Perioperative outcomes, including intraoperative estimated blood loss (EBL), complications (overall, intraoperative, and 30-day postoperative), and hospital length of stay (LOS), were compared. The chi-square test, Fisher exact test, or 2-tailed Student t-test were used when appropriate. Results One hundred twenty-seven patients were included in the final analysis; 49 underwent open TLIF and 78 underwent MI TLIF. Sixty-one patients had Class I obesity (23 open and 38 MI TLIF); 45 patients, Class II (19 open and 26 MI); and 21 patients, Class III (7 open and 14 MI). Overall, mean EBL was 397.2 ml and mean hospital LOS was 3.7 days. Minimally invasive TLIF was associated with significantly less EBL and a shorter hospital stay than open TLIF when all patients were evaluated as a single cohort and within individual obesity classes. Overall, the complication rate was 18.1%. Minimally invasive TLIF was associated with a significantly lower total complication rate (11.5% MI vs 28.6% open) and intraoperative complication rate (3.8% MI vs 16.3% open) as compared with open TLIF. When stratified by obesity class, MI TLIF was still associated with lower rates of total and intraoperative complications. This effect was most profound and statistically significant in patients with Class III obesity (42.9% open vs 7.1% MI). Conclusions Minimally invasive TLIF offers obese patients perioperative benefits similar to those seen in patients with normal BMI who undergo the same procedure. These benefits include less EBL, a shorter hospital stay, and potentially fewer complications compared with open TLIF. Additional large retrospective studies and randomized prospective studies are needed to verify these findings.

scholarly journals Parenchymal-sparing hepatectomy for colorectal liver metastases reduces postoperative morbidity while maintaining equivalent oncologic outcomes compared to non-parenchymal-sparing resection

2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
A Andreou ◽  
S Gloor ◽  
J Inglin ◽  
C Di Pietro Martinelli ◽  
V Banz ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Hospital Stay ◽  
Complication Rate ◽  
Colorectal Liver Metastases ◽  
Postoperative Morbidity ◽  
Length Of Hospital Stay ◽  
Tumor Burden ◽  
Minimal Invasive ◽  
Oncologic Outcomes

Abstract Objective Modern chemotherapy and repeat hepatectomy allow to tailor the surgical strategies for the treatment of colorectal liver metastases (CRLM). This study addresses the hypothesis that parenchymal-sparing hepatectomy reduces postoperative complications while ensuring similar oncologic outcomes compared to the standardized non-parenchymal-sparing procedures. Methods Clinicopathological data of patients who underwent liver resection for CRLM between 2012 and 2019 at a major hepatobiliary center in Switzerland were assessed. Patients were stratified according to the tumor burden score [TBS2 = (maximum tumor diameter in cm)2 + (number of lesions)2)] and were dichotomized in a lower and a higher tumor burden cohort according to the median TBS. Postoperative outcomes, overall survival (OS) and disease-free survival (DFS) of patients following parenchymal-sparing resection (PSR) for CRLM were compared with those of patients undergoing non-PSR. Results During the study period, 153 patients underwent liver resection for CRLM with curative intent. PSR was performed in 79 patients with TBS < 4.5, and in 42 patients with TBS ≥ 4.5. In patients with lower tumor burden (TBS < 4.5), PSR was associated with lower complication rate (15.2% vs. 46.2%, p = 0.009), and shorter length of hospital stay (5 vs. 9 days, p = 0.006) in comparison to non-PSR. For TBS < 4.5, PSR resulted in equivalent 5-year OS (48% vs. 39%, p = 0.479) and equivalent 5-year DFS rates (DFS, 44% vs. 29%, p = 0.184) compared to non-PSR. For TBS ≥ 4.5, PSR resulted in lower postoperative complication rate (33.3% vs. 63.2%, p = 0.031), lower length of hospital stay (6 vs. 9 days, p = 0.005), equivalent 5-year OS (29% vs. 22%, p = 0.314), and equivalent 5-year DFS rates (29% vs. 22%, p = 0.896) compared to non-PSR. Among all patients treated with PSR, patients undergoing minimal-invasive hepatectomy had equivalent 5-year OS (42% vs. 37%, p = 0.261) and equivalent 5-year DFS (34% vs. 34%, p = 0.613) rates compared to patients undergoing open hepatectomy. Conclusion PSR for CRLM is associated with lower postoperative morbidity, shorter length of hospital stay, and equivalent oncologic outcomes compared to non-PSR independently from tumor burden. Our findings suggest that minimal-invasive PSR should be considered as the preferred method for the treatment of curatively resectable CRLM if allowed by tumor size and location.

Minimally invasive liver surgery for metastases from colorectal cancer: oncologic outcome and prognostic factors

2012 ◽  
Vol 26 (8) ◽  
pp. 2288-2298 ◽  
Author(s):  
Baki Topal ◽  
Joyce Tiek ◽  
Steffen Fieuws ◽  
Raymond Aerts ◽  
Eric Van Cutsem ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Minimally Invasive ◽  
Liver Surgery ◽  
Oncologic Outcome ◽  
Minimally Invasive Liver Surgery

scholarly journals Minimally invasive liver surgery: a field is maturing

2019 ◽  
Vol 3 ◽  
pp. 34-34
Author(s):  
Elisabeth Sucher ◽  
Robert Sucher
Keyword(s):  
Minimally Invasive ◽  
Liver Surgery ◽  
Minimally Invasive Liver Surgery

Integrated MR-laparoscopy system with respiratory synchronization for minimally invasive liver surgery

2009 ◽  
Vol 17 (5) ◽  
pp. 622-628 ◽  
Author(s):  
Yuichiro Matsuoka ◽  
Etsuko Kumamoto ◽  
Maki Sugimoto ◽  
Takeshi Azuma ◽  
Akito Saito ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Liver Surgery ◽  
Minimally Invasive Liver Surgery ◽  
Respiratory Synchronization

Impact of Immune Response in Short-term and Long-term Outcomes After Minimally Invasive Surgery for Colorectal Liver Metastases

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Victor Lopez-Lopez ◽  
Alvaro Gómez Ruiz ◽  
Pablo Pelegrin ◽  
Beatriz Abellán ◽  
Asunción Lopez-Conesa ◽  
...  
Keyword(s):  
Immune Response ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Colorectal Liver Metastases ◽  
Long Term Outcomes ◽  
Short Term
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