scholarly journals O-L01 Learning curve for laparoscopic liver resection: does it affect survival in colorectal liver metastasis?

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Hiba Shanti ◽  
Rakesh Raman ◽  
Saurav Chakravartty ◽  
Ajay P. Belgaumkar ◽  
Ameet G. Patel
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Blood Loss ◽  
Learning Curve ◽  
Colorectal Liver Metastasis ◽  
Laparoscopic Liver Resection ◽  
R0 Resection ◽  
Recurrence Free Survival ◽  
Term Survival ◽  
Free Survival

Abstract Background After Gagner introduced laparoscopic liver resection (LLR) in 1992, it was not until 2004 that the first series with more than ten laparoscopic major liver resections was reported. Furthermore, a multicentre study by Allard et al., in 2015 revealed that laparoscopy was only used in 176 (6.7%) patients out of a total of 2620 patients treated for colorectal liver metastasis (CRLM). This lag time in the establishment of LLR was attributed to the steep learning curve (LC) due to technical complexity and caution about oncological safety. The aim of this study is to assess if the learning curve of LLR has affected survival of patients with CRLM. Methods All consecutive LLR performed by a single surgeon between 2000–2019 were retrospectively analysed. RA-CUSUM for conversion rate and the log regression analysis of the blood loss were used to identify two phases in the learning curve. LC was then applied to CRLM patients and the two subgroups were compared for oncological and survival outcomes. The analysis was repeated with propensity score-matched (PSM) groups Results A total of 286 patients were included in the learning curve analysis. Combining the results from the RA-CUSUM and the blood loss log curve identified two distinct phases in the learning curve. The early phase (EP, n = 68) represented the initial learning experience, and the late phase (LP, n = 218) represented increased competence and the introduction of more challenging cases. The LC was applied to 192 patients with colorectal liver metastasis (EPc n = 45, LPc n = 147). R0 resection was achieved in 93%; 100% in EPc and 90% in LPc (P = .02). The cohort median overall survival (OS) and was 60 months. The median recurrence-free survival (RFS) was 16 months. The 5- year OS and RFS were 51% and 33%, respectively. The overall and recurrence-free survival rates were not compromised by the learning curve; OS (HR: 0.78, 95% CI 0.51-1.2, p = .26), RFS (HR: 0.94, 95 % CI 0.64-1.37, p=.76). Results were replicated after PSM. Conclusions In our experience, the development of a laparoscopic liver resection program can be achieved without adverse effect on the long-term survival in CRLM.

scholarly journals Impact of postoperative complications on long-term survival of hepatocellular carcinoma patients after liver resection

2021 ◽  
Author(s):  
Susumu Mochizuki ◽  
Hisashi Nakayama ◽  
Yutaka Midorikawa ◽  
Tokio Higaki ◽  
Masamichi Moriguchi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Resection ◽  
Pleural Effusion ◽  
Postoperative Complications ◽  
Recurrence Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival

Objective The effect of postoperative complications including red blood transfusion (BT) on long-term survival for hepatocellular carcinoma (HCC) is unknown. The purpose of this study was to define the relationship between postoperative complications and long-term survival in patients with HCC. Methods Postoperative complications of 1251 patients who underwent curative liver resection for HCC were classified, and their recurrence-free survival (RFS) and cumulative overall survival (OS) were investigated. Results Any complications occurred in 503 patients (40%). Five-year RFS and 5-year OS in the complication group were 21% and 56%, respectively, significantly lower than the respective values of 32% ( p < 0.001) and 68% ( p < 0.001) in the no-complication group (n=748). Complications related to RFS were postoperative BT [Hazard ratio (HR): 1.726, 95% confidence interval (CI): 1.338–2.228, p < 0.001], pleural effusion [HR: 1.434, 95% CI: 1.200–1.713, p < 0.001] using Cox-proportional hazard model. Complications related to OS were postoperative BT [HR: 1.843, 95%CI: 1.380-2.462, p < 0.001], ascites [HR: 1.562, 95% CI: 1.066–2.290 p = 0.022], and pleural effusion [HR: 1.421, 95% CI: 1.150–1.755, p = 0.001). Conclusions Postoperative complications were factors associated with poor long-term survival. Postoperative BT and pleural effusion, were noticeable complications that were prognostic factors for both recurrence-free survival and overall survival.

Two-stage laparoscopic liver resection for bilateral colorectal liver metastasis

2010 ◽  
Vol 24 (8) ◽  
pp. 2044-2047 ◽  
Author(s):  
M. A. Machado ◽  
F. F. Makdissi ◽  
R. C. Surjan ◽  
G. T. Kappaz ◽  
N. Yamaguchi
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Laparoscopic Liver Resection ◽  
Two Stage

scholarly journals The Impact of Sarcopenia on Overall and Disease-free Survival after Liver Resection for Colorectal Liver Metastasis

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S735
Author(s):  
C.F. Fernández Mancilla ◽  
R. Rumenova Smilevska ◽  
B. Madrid Baños ◽  
J. Aparicio Navarro ◽  
M. Pujante Menchon ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Disease Free Survival ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

Evolving Role of Hepatic Resection for Metastatic Urologic Malignancies

2017 ◽  
Vol 83 (6) ◽  
pp. 628-632 ◽  
Author(s):  
John B. Hamner ◽  
Mustafa Raoof ◽  
Sinziana Dumitra ◽  
Hans F. Schoellhammer ◽  
Carly Crowder ◽  
...  
Keyword(s):  
Liver Resection ◽  
Hepatic Resection ◽  
Disease Free Survival ◽  
Perioperative Outcomes ◽  
R0 Resection ◽  
Term Survival ◽  
Free Survival ◽  
Urologic Malignancies ◽  
Disease Free

Liver resection for noncolorectal, nonneuroendocrine metastases remains controversial. Here, we evaluate a single institutional experience with hepatic resection for metastatic urologic malignancies. A single-institution review of patients who underwent hepatic resection for metastatic urologic tumors between the years of 2000 and 2013 was performed. Patient charts were analyzed for pathologic data and perioperative outcomes including short- and long-term morbidity, mortality, and overall and disease-free survival. Eleven patients were identified who underwent hepatic resection for metastatic urologic malignancy. The mean age was 63.5 years. All patients had an R0 resection. There were three major complications. Mean length of stay was 6.5 days and there was no 90-day mortality. Three patients have died of recurrent disease at an average of 11.2 months from resection to death. The remaining patients are still alive during a mean follow-up of 31.5 months. Five-year overall and disease-free survival was 50 and 21 months, respectively. Hepatic resection for metastatic urologic tumors is safe with low morbidity and mortality and durable long-term survival can be achieved. Liver resection for isolated hepatic disease should be considered for this rare metastatic disease to the liver.

scholarly journals The smallest colorectal liver metastasis size as a prognosis factor after laparoscopic liver resection

2019 ◽  
Vol 30 ◽  
pp. v213
Author(s):  
B. Cervantes ◽  
B. Gayet ◽  
F. Frosio ◽  
N. Tabchouri ◽  
M. Bennamoun ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Laparoscopic Liver Resection ◽  
Prognosis Factor
Sign in / Sign up

Export Citation Format

Share Document