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. 2009;16(6):720-5.
doi: 10.1007/s00534-009-0139-x. Epub 2009 Aug 4.

Laparoscopic hepatectomy for liver tumors: proposals for standardization

Yuichiro Otsuka  1 , Masaru Tsuchiya, Tetsuya Maeda, Toshio Katagiri, Jun Isii, Akira Tamura, Kunihiro Yamazaki, Yoshihisa Kubota, Takashi Suzuki, Takayuki Suzuki, Satoru Kagami, Hironori Kaneko
Affiliations

Laparoscopic hepatectomy for liver tumors: proposals for standardization

Yuichiro Otsuka et al. J Hepatobiliary Pancreat Surg. 2009.

Abstract

Background/purpose: We draw on our experience with laparoscopic hepatectomy (LH) to present recommendations for standardization of LH for the treatment of liver tumors.

Methods: At our center, 90 LHs were performed from April 1993 to January 2008. These were divided equally into early cases and late cases, and short-term postoperative results were compared. Forty-nine of the LH procedures were total-laparoscopic procedures, 16 were hand-assisted procedures, and 25 were laparoscopy-assisted procedures. The tumors were malignant in 76 cases and benign in 14 cases.

Results: Among late cases, the numbers of malignant tumors and tumors located in the posterosuperior region of the liver (Segments VII, VIII, and IVb) were significantly higher than among early cases; however, operative blood loss and postoperative hospital stay were significantly lower in the late cases (158.9 +/- 213.4 vs. 377.6 +/- 421.2 cc, P = 0.007; and 8.7 +/- 3.6 vs. 15.3 +/- 8.7 days, P = 0.0001, respectively). No operative deaths occurred in either group.

Conclusions: Although LH does have a steep learning curve, we believe that it can be standardized and provide a less invasive surgical option--with no reduction in disease curability--for the treatment of liver tumors in selected patients.

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