Laparoscopic Liver Resection for Malignant Liver Tumors

摘要: OBJECTIVE: To assess the feasibility, safety, and outcome of laparoscopic liver resection for malignant tumors. SUMMARY BACKGROUND DATA: The precise role laparoscopy in malignancies (hepatocellular carcinoma [HCC] metastases) remains controversial despite an increasing number publications reporting benign METHODS: A retrospective study was performed 11 surgical centers Europe regarding their experience with malignancies. Detailed questionnaires were sent to each surgeon focusing on patient characteristics, clinical data, type characteristics tumor, technical details operation, early late outcome. All patients had radiologic investigations at follow-up exclude disease recurrence. RESULTS: From February 1994 December 2000, 37 tumors included this study. Ten HCC, including 9 cirrhotic liver, 27 metastases. mean tumor size 3.3 cm, 89% located left lobe or anterior segments right liver. Liver procedures 12 wedge resections, segmentectomies, 14 bisegmentectomies (including 13 lateral segmentectomies), 2 major hepatectomies. transfusion rate, use pedicular clamping, conversion rate (13.5% whole series), complication significantly greater HCC. There no deaths. Postoperative complications occurred eight (22%). margin less than 1 cm 30% patients. During a months, 2-year disease-free survival 44% HCC 53% having hepatic metastases from colorectal cancer. No port-site observed during follow-up. CONCLUSIONS: In small tumors, is feasible safe. low, except By using ultrasound, 1-cm free should be routinely obtained. needs evaluated expert centers.