Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon
Abstract Background Laparoscopic liver resection has been regarded as the standard treatment for liver tumors located at the left lateral liver sector. However, few studies have reported the results of laparoscopic left lateral sectionectomy (LLS) for HCC, not to mention the feasibility of this emer...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-018-0903-y |
| _version_ | 1818318694299729920 |
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| author | Chao-Wei Lee Hsin-I Tsai Hao-Tsai Cheng Wei-Ting Chen Heng-Yuan Hsu Chien-Chih Chiu Yi-Ping Liu Tsung-Han Wu Ming-Chin Yu Wei-Chen Lee Miin-Fu Chen |
| author_facet | Chao-Wei Lee Hsin-I Tsai Hao-Tsai Cheng Wei-Ting Chen Heng-Yuan Hsu Chien-Chih Chiu Yi-Ping Liu Tsung-Han Wu Ming-Chin Yu Wei-Chen Lee Miin-Fu Chen |
| author_sort | Chao-Wei Lee |
| collection | DOAJ |
| description | Abstract Background Laparoscopic liver resection has been regarded as the standard treatment for liver tumors located at the left lateral liver sector. However, few studies have reported the results of laparoscopic left lateral sectionectomy (LLS) for HCC, not to mention the feasibility of this emerging technique for the less experienced liver surgeons. The current study would reappraise the Louisville statement by examining the outcome of LLS performed by a young liver surgeon. Methods We retrospectively reviewed two separate groups of patients who underwent open or laparoscopic left lateral sectionectomies at Chung Gung Memorial Hospital, Linkou. All laparoscopic hepatectomies were performed by the index young surgeon following a stepwise stapleless LLS. The surgical results and oncological outcomes of laparoscopic vs. open hepatectomies (LH and OH, respectively) with the surgical indication of HCC at left lateral liver sector were further compared and analyzed. Results 18 of 29 patients in the laparoscopic group and 75 patients in the conventional open group had primary HCC. The demographic data was essentially the same for the two groups. Statistical analysis revealed that the LH group had smaller tumor size, higher blood transfusion requirement, longer duration of inflow control and parenchymal transection, and longer operation time. However, no significant difference was observed in terms of complication rate, mortality rate, and hospital stay between the two groups. After adjusting for tumor size, LH and OH showed no statistical difference in the amount of blood transfusion, operation time and patient survival. Conclusions This study demonstrated that stapleless LLS is a safe and feasible procedure for less experienced liver surgeons to resect HCC located at the left lateral liver sector. This stepwise stapleless LSS can not only achieve surgical results comparable to OH but also can provide a platform for liver surgeons to apply laparoscopic technique before conducting more complicated liver resections. |
| first_indexed | 2024-12-13T09:57:17Z |
| format | Article |
| id | doaj.art-b44548f378df4fd4a067d4b278918968 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T09:57:17Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-b44548f378df4fd4a067d4b2789189682022-12-21T23:51:45ZengBMCBMC Gastroenterology1471-230X2018-11-0118111010.1186/s12876-018-0903-yStapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeonChao-Wei Lee0Hsin-I Tsai1Hao-Tsai Cheng2Wei-Ting Chen3Heng-Yuan Hsu4Chien-Chih Chiu5Yi-Ping Liu6Tsung-Han Wu7Ming-Chin Yu8Wei-Chen Lee9Miin-Fu Chen10Department of Surgery, Linkou Chang Gung Memorial HospitalGraduate Institute of Clinical Medical Sciences, Chang Gung UniversityCollege of Medicine, Chang Gung UniversityDepartment of Gastroenterology and Hepatology, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalDepartment of Nursing, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalDepartment of Surgery, Linkou Chang Gung Memorial HospitalAbstract Background Laparoscopic liver resection has been regarded as the standard treatment for liver tumors located at the left lateral liver sector. However, few studies have reported the results of laparoscopic left lateral sectionectomy (LLS) for HCC, not to mention the feasibility of this emerging technique for the less experienced liver surgeons. The current study would reappraise the Louisville statement by examining the outcome of LLS performed by a young liver surgeon. Methods We retrospectively reviewed two separate groups of patients who underwent open or laparoscopic left lateral sectionectomies at Chung Gung Memorial Hospital, Linkou. All laparoscopic hepatectomies were performed by the index young surgeon following a stepwise stapleless LLS. The surgical results and oncological outcomes of laparoscopic vs. open hepatectomies (LH and OH, respectively) with the surgical indication of HCC at left lateral liver sector were further compared and analyzed. Results 18 of 29 patients in the laparoscopic group and 75 patients in the conventional open group had primary HCC. The demographic data was essentially the same for the two groups. Statistical analysis revealed that the LH group had smaller tumor size, higher blood transfusion requirement, longer duration of inflow control and parenchymal transection, and longer operation time. However, no significant difference was observed in terms of complication rate, mortality rate, and hospital stay between the two groups. After adjusting for tumor size, LH and OH showed no statistical difference in the amount of blood transfusion, operation time and patient survival. Conclusions This study demonstrated that stapleless LLS is a safe and feasible procedure for less experienced liver surgeons to resect HCC located at the left lateral liver sector. This stepwise stapleless LSS can not only achieve surgical results comparable to OH but also can provide a platform for liver surgeons to apply laparoscopic technique before conducting more complicated liver resections.http://link.springer.com/article/10.1186/s12876-018-0903-yLaparoscopic hepatectomyLiver resectionLeft lateral sectionectomyHepatocellular carcinomaHepatomaStapleless |
| spellingShingle | Chao-Wei Lee Hsin-I Tsai Hao-Tsai Cheng Wei-Ting Chen Heng-Yuan Hsu Chien-Chih Chiu Yi-Ping Liu Tsung-Han Wu Ming-Chin Yu Wei-Chen Lee Miin-Fu Chen Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon BMC Gastroenterology Laparoscopic hepatectomy Liver resection Left lateral sectionectomy Hepatocellular carcinoma Hepatoma Stapleless |
| title | Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon |
| title_full | Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon |
| title_fullStr | Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon |
| title_full_unstemmed | Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon |
| title_short | Stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma: reappraisal of the Louisville statement by a young liver surgeon |
| title_sort | stapleless laparoscopic left lateral sectionectomy for hepatocellular carcinoma reappraisal of the louisville statement by a young liver surgeon |
| topic | Laparoscopic hepatectomy Liver resection Left lateral sectionectomy Hepatocellular carcinoma Hepatoma Stapleless |
| url | http://link.springer.com/article/10.1186/s12876-018-0903-y |
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