Minimally-invasive liver resection in pediatric patients: initial experience and outcomes.
Minimally Invasive Liver Resection (MILR) is an evolving procedure in the adult population for benign and malignant lesions, offering less morbidity while maintaining acceptable outcomes. However, there lacks a published MILR experience in the pediatric population besides case reports. This report describes a pediatric MILR experience in terms of pathology, clinical specifics, and patient outcomes.



This is a retrospective review of 36 pediatric patients undergoing MILR for benign and malignant conditions. MILR was performed by pure laparoscopy, hand-assisted laparoscopy, and a hybrid laparoscopic assisted method. Data points reviewed include patient demographics, pathology, operative technique, complications, and recurrence.



Patients with benign (15) and malignant (21) conditions underwent segmentectomy, sectionectomy, or hemihepatectomy by MILR. Thirty-one were completed with pure laparoscopy and 20 underwent hemihepatectomy. Operative time and blood loss correlated with magnitude of resection with five patients requiring a blood transfusion. Complications were minor and included a seroma, port infection, port dehiscence, line infection, and hypertrophic scar. At median follow-up of 12 months (range 6-36 months), there were no mortalities, re-operations, or recurrences.



MILR can be performed in pediatric patients for benign and malignant conditions with good technical and oncologic outcomes and low morbidity.
Oakland University, William Beaumont School of Medicine, Beaumont Health Systems, Department of Surgery, Division of Pediatric Surgery, USA. Electronic address: michelle.veenstra@beaumont.org.
Michelle A
MA
Veenstra
Oakland University, William Beaumont School of Medicine, Beaumont Health Systems, Department of Surgery, Division of Pediatric Surgery, USA.
Alan J
AJ
Koffron
D000293:Adolescent; D000367:Age Factors; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D058733:Hand-Assisted Laparoscopy / Q000009:adverse effects / Q000401:mortality; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D008107:Liver Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome