Laparoscopic-assisted limited liver resection: technique, indications and results.
OBJECTIVE
The purpose of this work was to evaluate the short-term results of laparoscopic-assisted limited liver resection.


METHODS
We analyzed the clinical outcome in 17 patients (mean age 70 +/- 8 years) who had undergone laparoscopic-assisted limited liver resection from March 2006 to December 2008. Preoperative diagnoses were HCC in 13 patients and metastasis of colon cancer in 4. The operation consisted of laparoscopic mobilization of the target liver lobe, followed by open liver resection through a 7- to 10-cm extraction site.


RESULTS
Mean tumor size was 3.0 +/- 1.1 cm (range 1.2-5 cm). The mean operative time was 362 +/- 85 min. The mean blood loss was 451 +/- 413 ml, and no blood transfusion was required in any patient. There were no intraoperative complications, and conversion to laparotomy was needed in one case. Postoperative complications developed in 4 cases (4 infections, 24%), all of which were improved by conservative management. However, there was no postoperative mortality. None of the patients had any peritoneal carcinomatosis or port-site or resection site recurrence during a mean follow-up of 18 +/- 9.6 months. According to the analysis of the tumor location, the criterion for an adequate tumor location in the right lobe for this operation was set with the tumor at a distance of more than 5 cm from the inferior vena cava and the root of the hepatic vein (5 cm rule).


CONCLUSIONS
Laparoscopic-assisted limited liver resection is feasible and well tolerated. Accumulation of more data may be needed for evaluation of long-term outcome.
Itano
Osamu
O
Endoscopic Surgery Center, Eiju General Hospital, Tokyo, Japan. itano@eijuhp.com
Chiba
Naokazu
N
Maeda
Shingo
S
Matsui
Hideo
H
Oshima
Go
G
Wada
Takeyuki
T
Nakayama
Takashi
T
Ishikawa
Hideki
H
Koyama
Yasumasa
Y
Kitagawa
Yuko
Y
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000601:surgery*; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome