Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi-institutional study of 245 patients. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Controversy exists regarding the safety and feasibility of minimally invasive resection for lesions in segments 7 or 8. We compare outcomes of minimally invasive surgery (MIS) and Open parenchymal sparing liver resections at two high-volume centers. METHODS: From 2003 to 2016 we identified patients who underwent MIS or Open resections for lesions in segments 7 or 8 at two institutions (MSKCC and SGH). Outcomes were compared using univariate and multivariate analyses. RESULTS: Two-hundred and forty-five patients underwent resection of lesions in segments 7 or 8 (MIS 30% and Open 70%). Compared to the Open group, the MIS group had longer operative time (223 ± 88 vs 188 ± 72 minutes, P = .003), lower blood loss (297 ± 287 vs 448 ± 670 mL, P = .03), and shorter mean length of stay (5.2 ± 7.4 vs 8.3 ± 11.7 days, P < .001), which remained significant on multivariate analysis. No differences in Pringle time, rate of postoperative complications, or R0 resections were detected. CONCLUSIONS: With appropriately selected patients treated by experienced MIS hepatopancreatobiliary surgeons, MIS resection of segments 7 or 8 is safe with similar rates of complications and R0 resections, with significantly less blood loss and shorter length of stay.

publication date

  • August 16, 2020

Research

keywords

  • Hepatectomy
  • Laparoscopy
  • Length of Stay
  • Liver Neoplasms
  • Minimally Invasive Surgical Procedures

Identity

PubMed Central ID

  • PMC7978501

Scopus Document Identifier

  • 85089362342

Digital Object Identifier (DOI)

  • 10.1002/jso.26154

PubMed ID

  • 33459363

Additional Document Info

volume

  • 122

issue

  • 7