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Erschienen in: Annals of Surgical Oncology 4/2015

01.04.2015 | Hepatobiliary Tumors

Pure Laparoscopic Liver Resection for Large Malignant Tumors: Does Size Matter?

verfasst von: Vishal G. Shelat, FRCS, FICS, Federica Cipriani, MD, Tiago Basseres, MD, Thomas H. Armstrong, FRCS, PhD, Arjun S. Takhar, FRCS, PhD, Neil W. Pearce, FRCS, PhD, Mohammad AbuHilal, MD, FRCS, PhD DocEurp

Erschienen in: Annals of Surgical Oncology | Ausgabe 4/2015

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Abstract

Background

Laparoscopic liver resection (LLR) for large malignant tumors can be technically challenging. Data on this topic are scarce, and many question its feasibility, safety, and oncologic efficiency. This study aimed to assess outcomes of LLR for large (≥5 cm) and giant (≥10 cm) malignant liver tumors.

Methods

A prospectively collected database of 422 LLRs was reviewed from August 2003 to August 2013. The data for 52 patients undergoing LLR for large malignant tumors were analyzed. A subgroup analysis of giant tumors also is reported.

Results

During the period studied, 52 LLRs were performed (males, 53.8 %; mean age, 64.6 years) for large malignant tumors. Colorectal liver metastasis was the most common indication (42.3 %). The 52 LLRs included 32 major (61.5 %) and 20 minor (38.5 %) LLRs for tumors with a mean diameter of 83 mm. The median operative time was 240 min [interquartile range (IQR), 150–330 min], and the blood loss was 500 ml (IQR, 200–1,373 ml). Eight conversions (15.4 %) were performed. Six patients experienced complications (11.5 %). Among the 44 patients with successful LLRs, two patients (4.5 %) had an R1 resection. The median hospital stay was 5 days (range, 1–21 days), and no mortality occurred during a 90-day period. A subgroup analysis of patients with giant tumors showed greater blood loss (p = 0.002) and a longer operative time (p = 0.052) but no difference in terms of conversions (p = 0.64) or complications (p = 0.32).

Conclusion

The findings showed that LLR is feasible and safe for large malignant tumors and can be performed with acceptable morbidity and oncologic efficiency. When used for giant malignant tumors, LLR is associated with greater blood loss and a longer operative time but no increase in complications.
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Metadaten
Titel
Pure Laparoscopic Liver Resection for Large Malignant Tumors: Does Size Matter?
verfasst von
Vishal G. Shelat, FRCS, FICS
Federica Cipriani, MD
Tiago Basseres, MD
Thomas H. Armstrong, FRCS, PhD
Arjun S. Takhar, FRCS, PhD
Neil W. Pearce, FRCS, PhD
Mohammad AbuHilal, MD, FRCS, PhD DocEurp
Publikationsdatum
01.04.2015
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 4/2015
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4107-6

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