Laparoscopic liver resection for malignant and benign lesions: ten-year Norwegian single-center experience.
BACKGROUND
The introduction of laparoscopic liver resection has been challenging because new and safe surgical techniques have had to be developed, and skepticism remains about the use of laparoscopy for malignant neoplasms. We present herein a large-volume single-center experience with laparoscopic liver resection.


METHODS
Retrospective study.


METHODS
Rikshospitalet University Hospital.


METHODS
One hundred thirty-nine patients who underwent 177 laparoscopic liver resections in 149 procedures from August 18, 1998, through October 14, 2008. One hundred thirteen patients had malignant lesions, of whom 96 had colorectal metastases.


METHODS
Laparoscopic liver resection for malignant and benign lesions.


METHODS
Perioperative and oncologic outcomes and survival.


RESULTS
Five procedures (3.4%) were converted to laparotomy and 1 (0.7%) to laparoscopic radiofrequency ablation. The remaining 143 procedures were completed laparoscopically, during which 177 liver resections were undertaken, including 131 nonanatomic and 46 anatomic resections. The median operative time and blood loss were 164 (50-488) minutes and 350 (<50-4000) mL, respectively. There were 10 intraoperative (6.7%) and 18 postoperative (12.6%) complications. One patient (0.7%) died. The median postoperative stay and opioid requirement were 3 (1-42) and 1 (0-11) days, respectively. Tumor-free resection margins determined by histopathologic evaluation were achieved in 140 of 149 malignant specimens (94.0%). The 5-year actuarial survival for patients undergoing procedures for colorectal metastases was 46%.


CONCLUSIONS
In experienced hands, laparoscopic liver resection is a favorable alternative to open resection. Perioperative morbidity and mortality and long-term survival after laparoscopic resection of colorectal metastases appear to be comparable to those after open resections.
Kazaryan
Airazat M
AM
Interventional Centre, Rikshospitalet University Hospital, Oslo, Norway. kazaryan@gmail.com
Pavlik Marangos
Irina
I
Rosseland
Arne R
AR
Røsok
Bård I
BI
Mala
Tom
T
Villanger
Olaug
O
Mathisen
Oystein
O
Giercksky
Karl-Erik
KE
Edwin
Bjørn
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009664:Norway; D012189:Retrospective Studies; D016019:Survival Analysis; D055815:Young Adult