TY - JOUR
T1 - Laparoscopic partial liver resection improves the short-term outcomes compared to open surgery for liver tumors in the posterosuperior segments
AU - Morikawa, Takanori
AU - Ishida, Masaharu
AU - Takadate, Tatsuyuki
AU - Aoki, Takeshi
AU - Ohtsuka, Hideo
AU - Mizuma, Masamichi
AU - Hayashi, Hiroki
AU - Nakagawa, Kei
AU - Motoi, Fuyuhiko
AU - Naito, Takeshi
AU - Unno, Michiaki
N1 - Publisher Copyright:
© 2018, Springer Nature Singapore Pte Ltd.
PY - 2019/3/8
Y1 - 2019/3/8
N2 - Purpose: The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments. Methods: The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed. Results: In the case-matched study, the laparoscopic technique required a longer operation time (p = 0.001), but was associated with less intraoperative blood loss (p = 0.021), a lower incidence of major complications (p = 0.014), higher levels of serum albumin on postoperative days 3 and 7 (p = 0.031 and p = 0.035), and earlier discharge (p = 0.001) than open resection. The results of the latter study were similar to those of the case-matched analysis. Conclusions: Laparoscopic partial hepatectomy was a feasible procedure for treating tumors in the posterosuperior segments without compromising oncological safety and yielded better short-term outcomes than open techniques. In addition, this study provides concrete selection criteria for laparoscopic partial hepatectomy for difficult lesions.
AB - Purpose: The aim of this study was to compare the clinical outcomes between laparoscopic partial liver resection and open partial hepatectomy for tumors in the posterosuperior segments. Methods: The clinical outcomes of patients who underwent either laparoscopic (n = 20) or open (n = 44) resection in segments 7/8 of the liver were initially evaluated. Because of disparities in the background characteristics, a case-matched study (1:1) was conducted. In addition, a comparative study of the patients who met the institutional criteria for laparoscopic partial hepatectomy was performed. Results: In the case-matched study, the laparoscopic technique required a longer operation time (p = 0.001), but was associated with less intraoperative blood loss (p = 0.021), a lower incidence of major complications (p = 0.014), higher levels of serum albumin on postoperative days 3 and 7 (p = 0.031 and p = 0.035), and earlier discharge (p = 0.001) than open resection. The results of the latter study were similar to those of the case-matched analysis. Conclusions: Laparoscopic partial hepatectomy was a feasible procedure for treating tumors in the posterosuperior segments without compromising oncological safety and yielded better short-term outcomes than open techniques. In addition, this study provides concrete selection criteria for laparoscopic partial hepatectomy for difficult lesions.
KW - Laparoscopic liver resection
KW - Laparoscopic partial hepatectomy
KW - Laparoscopic partial liver resection
KW - Parenchyma-preserving liver resection
KW - Posterosuperior segments
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U2 - 10.1007/s00595-018-1719-7
DO - 10.1007/s00595-018-1719-7
M3 - Article
C2 - 30251166
AN - SCOPUS:85053789604
VL - 49
SP - 214
EP - 223
JO - Surgery Today
JF - Surgery Today
SN - 0941-1291
IS - 3
ER -