Abstract
Introduction
All patients who underwent laparoscopic liver resections in the posterosuperior segments (LPSS) at our center were positioned in semiprone since August 2011. The aims of this study were to assess differences in perioperative outcomes between laparoscopic left lateral sectionectomies (LLLS) performed in supine position and LPSS in semiprone position.
Methods
We reviewed our prospectively collected database of all liver resections performed between January 2012 and January 2015. LLLS and LPSS were compared with respect to demographics and perioperative outcomes.
Results
Forty-five patients underwent LLLS (n = 20) or LPSS (n = 25). There were no differences in patient demographics or tumor diameter (p = 0.946). There were no conversions. Pringle maneuver was not used in both groups. There was no difference in peroperative central venous pressure (p = 0.511). The median operative time in the LLLS group was 100 min (60–260) and 160 min (95–270) in the LPSS group (p = 0.002) with median intraoperative blood loss in the LLLS group of 50 ml (0–550) versus a larger 150 ml (50–700) (p = 0.010) for patients receiving LPSS. No patients required transfusion. Intraoperative and postoperative complication rates were similar in both groups. Median hospital stay was 6 days in both groups (p = 0.554).
Conclusion
LPSS in semiprone can be performed with similar clinical outcomes as a minor laparoscopic liver resection except for longer operative time and larger intraoperative blood loss without the need for transfusion.
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References
Gagner M, Rheault M, Dubuc J (1992) Laparoscopic partial hepatectomy for liver tumor (abstract). Surg Endosc 6:99
Descottes B, Glineur D, Lachachi F, Valleix D, Paineau J, Hamy A et al (2003) Laparoscopic liver resection of benign liver tumors. Surg Endosc 17:23–30
Gamblin TC, Holloway SE, Heckman JT, Geller DA (2008) Laparoscopic resection of benign hepatic cysts: a new standard. J Am Coll Surg 207:731–736
Dagher I, O’Rourke N, Geller DA, Cherqui D, Belli G, Gamblin TC et al (2009) Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg 250:856–860
Dagher I, Di Giuro G, Dubrez J, Lainas P, Smadja C, Franco D (2009) Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg 198:173–177
Gayet B, Cavaliere D, Vibert E, Perniceni T, Levard H, Denet C et al (2007) Totally laparoscopic right hepatectomy. Am J Surg 194:685–689
Nitta N, Sasaki A, Fujita T, Itabashi H, Hoshikawa K, Takahara T et al (2010) Laparoscopy-assisted major liver resections employing a hanging maneuver. Ann Surg 251:450–453
Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I et al (2009) World consensus conference on laparoscopic surgery. The international position on laparoscopic liver surgery: the Louisville statement, 2008. Ann Surg 250:825–830
Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213
Azagra JS, Goergen M, Brondello S, Calmes MO, Philippe P, Schmitz B (2009) Laparoscopic liver sectionectomy 2 and 3 (LLS 2 and 3): towards the “gold standard”. J Hepato-Biliary-Pancreat Surg 16:422–426
Hashimoto T, Kokudo N, Orii R, Seyama Y, Sano K, Imamura H et al (2007) Intraoperative blood salvage during liver resection: a randomized controlled trial. Ann Surg 245:686–691
Dulucq JL, Wintringer P, Sabilini C, Berticelli J, Mahajna A (2005) Laparoscopic liver resections: a single center experience. Surg Endosc 19:886–891
Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez PL (2003) Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg 138:763–769
Troisi RI, Montalti R, Van Limmen JG, Cavaniglia D, Reyntjens K, Rogiers X et al (2014) Risk factors and management of conversions to an open approach in laparoscopic liver resection: analysis of 265 consecutive cases. HPB (Oxford) 16(1):75–82
Ikeda T, Yonemura Y, Ueda N, Kabashima A, Shirabe K, Taketomi A et al (2011) Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding. Surg Today 41(12):1592–1598
Ikeda T, Mano Y, Morita K, Hashimoto N, Kayashima H, Masuda A et al (2013) Pure laparoscopic hepatectomy in semiprone position for right hepatic major resection. Hepato-Biliary-Pancreat Sci 20(2):145–150
Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D (2007) Laparoscopic liver resections: results of 70 patients. Surg Endosc 21:619–624
Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B (2006) Laparoscopic liver resection. Br J Surg 93:67–72
Kokudo N, Tada K, Seki M, Ohta H, Azekura K, Ueno M et al (2001) Anatomical major resection versus nonanatomical limited resection for liver metastases from colorectal carcinoma. Am J Surg 181(2):153–159
de Jong MC, Mayo SC, Pulitano C, Lanella S, Ribero D, Strub J et al (2009) Repeat curative intent liver surgery is safe and effective for recurrent colorectal liver metastasis: results from an international multi-institutional analysis. J Gastrointest Surg 13(12):2141–2151
Viganò L, Russolillo N, Ferrero A, Langella S, Sperti E, Capussotti L (2012) Evolution of long-term outcome of liver resection for colorectal metastases: analysis of actual 5-year survival rates over two decades. Ann Surg Oncol 19(6):2035–2044
Tomlinson JS, Jarnagin WR, DeMatteo RP, Fong Y, Kornprat P, Gonen M et al (2007) Actual 10-year survival after resection of colorectal liver metastases defines cure. J Clin Oncol 25(29):4575–4580
von Heesen M, Schuld J, Sperling J, Grünhage F, Lammert F, Richter S et al (2012) Parenchyma-preserving hepatic resection for colorectal liver metastases. Langenbeck’s Arch Surg 397(3):383–395
Fisher SB, Kneuertz PJ, Dodson RM, Patel SH, Maithel SK, Sarmiento JM et al (2013) A comparison of right posterior sectorectomy with formal right hepatectomy: a dual-institution study. HPB 15(10):753–762
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All procedures performed were in accordance with the ethical standards of the institutional research committee (Institutinal Review Board approval (AZGS2015036 B396201524308).
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D’Hondt, M., Yoshihara, E., Vansteenkiste, F. et al. Laparoscopic parenchymal preserving hepatic resections in semiprone position for tumors located in the posterosuperior segments. Langenbecks Arch Surg 401, 255–262 (2016). https://doi.org/10.1007/s00423-016-1375-6
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DOI: https://doi.org/10.1007/s00423-016-1375-6