[Experiences of laparoscopic repeat hepatectomy for recurrent hepatic cancer after open hepatectomy].
We report 3 cases of recurrent hepatic cancer in patients who underwent laparoscopic repeat hepatectomy (LRH). Case 1: A 70-year-old female with ascending colon cancer and liver metastases underwent open right colectomy followed by open S5 resection. Seven months later, the patient experienced a recurrence in the lateral segment and underwent laparoscopy-assisted ( L-A) partial resection. The adhesiolysis around the left liver was performed through a 7-cm upper median incision. Partial resection of the lateral segment was performed by hand-assisted laparoscopic surgery (HALS) using a median incision. Case 2: A 63-year-old female with metachronous liver metastases from rectal cancer underwent open S4a and S5 resection. Nineteen months later, she experienced a recurrence in S4b and underwent an L-A S4b resection. Adhesiolysis around the previous hepatic transection was performed through a small upper median incision. Mobilization of the liver was performed by HALS. A hepatic transection of S4b was also performed in the upper median incision. Case 3: An 80-year-old female with hepatocellular carcinoma (HCC) recurrence in the lateral segment after open S4 resection underwent L-A lateral segmentectomy. An adhesiolysis, mobilization of the liver, and a hepatic transection were performed by HALS and hybrid technique as described in case 2. In a patient with a history of open hepatectomy, LRH may be extensively indicated by utilizing HALS or a hybrid procedure.
Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
Hiroyoshi
H
Matsukawa
Shigehiro
S
Shiozaki
Daisuke
D
Satoh
Kazuhiro
K
Yoshida
Hisanobu
H
Miyoshi
Hiroyuki
H
Araki
Hitoshi
H
Idani
Yasutomo
Y
Ojima
Masao
M
Harano
Takashi
T
Kanazawa
Noriaki
N
Tokumoto
Yasuhiro
Y
Choda
Soichirou
S
Miyake
Takuya
T
Kato
Naoki
N
Mimura
Kazutaka
K
Takahashi
Kenji
K
Yamaguchi
Masazumi
M
Okajima
Motoki
M
Ninomiya
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D012008:Recurrence