Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi-institutional study of 245 patients

Gholami, Sepideh, Judge, Sean J, Lee, Ser-Yee, Mashayekhi, Kiarash, Goh, Brian KP, Chan, Chung-Yip, Nuño, Miriam A, Gönen, Mithat, Balachandran, Vinod P, Allen, Peter J, Drebin, Jeffrey A, Jarnagin, William R, D' Angelica, Michael I, Kingham, Thomas Peter (December 2020) Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi-institutional study of 245 patients. Journal of Surgical Oncology, 122 (7). pp. 1428-1434. ISSN 0022-4790

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Abstract

BACKGROUND: Controversy exists regarding the safety and feasibility of minimally invasive resection for lesions in segments 7 or 8. We compare outcomes of minimally invasive surgery (MIS) and Open parenchymal sparing liver resections at two high-volume centers. METHODS: From 2003 to 2016 we identified patients who underwent MIS or Open resections for lesions in segments 7 or 8 at two institutions (MSKCC and SGH). Outcomes were compared using univariate and multivariate analyses. RESULTS: Two-hundred and forty-five patients underwent resection of lesions in segments 7 or 8 (MIS 30% and Open 70%). Compared to the Open group, the MIS group had longer operative time (223 ± 88 vs 188 ± 72 minutes, P = .003), lower blood loss (297 ± 287 vs 448 ± 670 mL, P = .03), and shorter mean length of stay (5.2 ± 7.4 vs 8.3 ± 11.7 days, P < .001), which remained significant on multivariate analysis. No differences in Pringle time, rate of postoperative complications, or R0 resections were detected. CONCLUSIONS: With appropriately selected patients treated by experienced MIS hepatopancreatobiliary surgeons, MIS resection of segments 7 or 8 is safe with similar rates of complications and R0 resections, with significantly less blood loss and shorter length of stay.

Item Type:	Paper
Subjects:	diseases & disorders > cancer diseases & disorders diseases & disorders > neoplasms organs, tissues, organelles, cell types and functions > organs types and functions > liver diseases & disorders > cancer > prognosis
CSHL Authors:	Gholami, Sepideh
Communities:	CSHL labs > Gholami Lab
SWORD Depositor:	CSHL Elements
Depositing User:	CSHL Elements
Date:	December 2020
Date Deposited:	29 Sep 2023 19:45
Last Modified:	29 Jan 2024 21:22
PMCID:	PMC7978501
Related URLs:	Publisher
URI:	https://repository.cshl.edu/id/eprint/41085

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