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Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes

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Abstract

Background

Standard oncologic liver resections performed on elderly patients (≥70 years old) have been shown to be safe and effective. The aim of this study was to analyze operative and oncologic short-term outcomes of totally laparoscopic liver resections (TLLR) performed on elderly patients for malignancies.

Methods

We performed a retrospective statistical analysis of prospectively recorded data of TLLR performed from October 2008 to February 2012 by a single hepato-pancreato-biliary (HPB) surgeon. Patients were divided into two groups according to age (<70 vs. ≥70 years old) and perioperative outcomes were compared.

Result

A total of 60 TLLR for malignancies were identified of which 25 patients (42 %) were aged ≥70 years (Group A) and 35 (58 %) were aged <70 years (Group B). There was no difference in operative time (170 vs. 180 min, p = 0.267), median blood loss (200 vs. 250 ml, p = 0.183), number and time of Pringle maneuver (p = 0.563 and p = 0.180), blood transfusion rate (4 vs. 17 %, p = 0.222), conversion rate (4 vs. 9 %, p = 0.443), morbidity rate (12 vs. 20 %, p = 0.797), and perioperative mortality rate (0 vs. 3 %, p = 0.688). An R0 resection was achieved in 92 (Group A) versus 83 % (Group B) (p = 0.265). At a median follow-up of 18 months, 12 % of patients in Group A experienced a disease recurrence with a related mortality rate similar to that of Group B (8 vs. 12 %, p = 0.375).

Conclusion

This retrospective comparative study shows that TLLR performed on elderly for liver neoplasm are feasible and safe and lead to short-term outcomes similar to those of younger patients.

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Acknowledgments

We thank Prof. G. Mudo’ from the Department Experimental Medicine and Clinical Neurosciences, Division of Human Physiology, University of Palermo (Italy) for her kindly assistance in the editing of the manuscript. Dr. Francesco Puleo is currently granted by Fonds Erasme, Brussels, Belgium.

Disclosures

Marcello G. Spampinato, Marianna Arvanitakis, Lucio Mandala’, Giuseppe Quarta, Donatella Traisci, Antonella Plaia, Nicola Di Bartolomeo, Giànandrea Baldazzi, and Umberto Cillo have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. HPB and Advanced Laparoscopic Surgical Unit, Department of General and Minimally Invasive Surgery, Policlinic of Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy

    Marcello Giuseppe Spampinato, Nicola Di Bartolomeo, Giànandrea Baldazzi & Umberto Cillo

  2. Department of Gastroenterology, Erasmus University Hospital, Brussels, Belgium

    Marianna Arvanitakis & Francesco Puleo

  3. HPB Unit, La Maddalena Cancer Center, Palermo, Italy

    Lucio Mandala

  4. Unit of Medical Oncology, Gallipoli General Hospital, Gallipoli, Italy

    Giuseppe Quarta

  5. Unit of Medical Oncology, Policlinic of Abano Terme, Abano Terme, Italy

    Donatella Traisci

  6. Department of Statistical and Mathematical Sciences, University of Palermo, Palermo, Italy

    Antonella Plaia

  7. Hepatobiliary and Liver Transplantation Unit, University of Padua, Padua, Italy

    Umberto Cillo

Authors
  1. Marcello Giuseppe Spampinato
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  2. Marianna Arvanitakis
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  3. Francesco Puleo
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  4. Lucio Mandala
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  7. Antonella Plaia
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  8. Nicola Di Bartolomeo
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  9. Giànandrea Baldazzi
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  10. Umberto Cillo
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Corresponding author

Correspondence to Marcello Giuseppe Spampinato.

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Spampinato, M.G., Arvanitakis, M., Puleo, F. et al. Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes. Surg Endosc 27, 1881–1886 (2013). https://doi.org/10.1007/s00464-012-2687-4

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  • DOI: https://doi.org/10.1007/s00464-012-2687-4

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