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. 2020 Mar;8(5):214.
doi: 10.21037/atm.2020.01.62.

Laparoscopic liver resection with simultaneous diaphragm resection

Airazat M Kazaryan  1   2   3   4 , Davit L Aghayan  2   4   5 , Åsmund A Fretland  2   5   6 , Vasiliy I Semikov  3 , Alexander M Shulutko  3 , Bjørn Edwin  2   5   6
Affiliations

Laparoscopic liver resection with simultaneous diaphragm resection

Airazat M Kazaryan et al. Ann Transl Med. 2020 Mar.

Abstract

Background: Liver resection or ablation remains the only curative treatment for patients with colorectal metastases. Simultaneous resection of tumors in the liver with invasion to the diaphragm is challenging and controversial. Therefore, we wanted to assess the safety of simultaneous laparoscopic liver and diaphragm resection (SLLDR) in a large single center.

Methods: Patients who underwent primary laparoscopic liver resection (LLR) for colorectal liver metastases at Oslo University Hospital between 2008 and 2019 were included in this study. Patients who underwent SLLDR (group 1) were compared to patients who underwent LLR only (group 2). Perioperative and oncologic outcomes were analyzed.

Results: A total of 467 patients were identified, of whom 12 patients needed a simultaneous diaphragm resection (group 1) while 455 underwent laparoscopic liver surgery alone (group 2). The conversion rate was 16.7% in group 1 and 2.4% in group 2 (P=0.040). In 10 of 12 (83.3%) cases the diaphragm resection was performed en bloc with the liver tumor. There was no significant difference in operative time, blood loss, resection margins, hospital stay or postoperative complications. One patient died within 30 postoperative days (0.2%) in group 2 and none in group 1. Overall survival was not statistically different between the groups.

Conclusions: In selected patients, SLLDR can be performed safely with good surgical and oncological outcomes.

Keywords: Laparoscopic hepatectomy; colorectal metastases; combined procedures; diaphragm resection.

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Conflict of interest statement

Conflicts of Interest: AMK serves as an unpaid editorial board member of Annals of Translational Medicine from Dec 2018 to Nov 2020. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves.
See this image and copyright information in PMC

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