Laparoscopic Parenchymal-Sparing Resections for Nonperipheral Liver Lesions, the Diamond Technique: Technical Aspects, Clinical Outcomes, and Oncologic Efficiency

摘要: Background Surgical management of liver lesions has moved toward "parenchymal-sparing" strategies. Although open parenchymal-sparing resections are supported by encouraging results, the applicability laparoscopic approach for nonperipheral tumors is still questionable. Our aim was to assess feasibility, safety, and oncologic adequacy resection with a description technique adopted in this setting. Study Design A prospectively collected single-center database 517 reviewed. Laparoscopic (LapPSLRs), that is, entirely intraparenchymal limited performed on lesions, were selected. Intra- perioperative outcomes analyzed along 3-year actuarial survival patients colorectal metastases. Results The group comprised 49 LapPSLRs. Colorectal metastases most frequent diagnosis (n = 24 patients). Lesions located segments 8, 7, 4a, 3 51%, 8.2%, 36.7%, 4.1% cases, respectively. Conversion occurred 4 (8%). postoperative short-term calculated isolated LapPSLR (not associated any concurrent resection). Median operative time blood loss 215 minutes 225 mL, Pringle maneuver used 75% cases. Postoperative 90-day mortality nil morbidity rate 12.5%. stay days. tumor-free margin mm 100% R0 achieved all LapPSLRs curative intent. Three-year overall, recurrence-free, disease-free rates 100%, 65.2%, 69.6%, Conclusions are feasible can be safely without compromising oncological outcomes.