Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi-institutional study of 245 patients

Sepideh Gholami, Sean J. Judge, Ser Yee Lee, Kiarash Mashayekhi, Brian K.P. Goh, Chung Yip Chan, Miriam A Nuno, Mithat Gönen, Vinod P. Balachandran, Peter J. Allen, Jeffrey A. Drebin, William R. Jarnagin, Michael I. D' Angelica, Thomas Peter Kingham

Research output: Contribution to journalArticle

Abstract

Background: Controversy exists regarding the safety and feasibility of minimally invasive resection for lesions in segments 7 or 8. We compare outcomes of minimally invasive surgery (MIS) and Open parenchymal sparing liver resections at two high-volume centers. Methods: From 2003 to 2016 we identified patients who underwent MIS or Open resections for lesions in segments 7 or 8 at two institutions (MSKCC and SGH). Outcomes were compared using univariate and multivariate analyses. Results: Two-hundred and forty-five patients underwent resection of lesions in segments 7 or 8 (MIS 30% and Open 70%). Compared to the Open group, the MIS group had longer operative time (223 ± 88 vs 188 ± 72 minutes, P =.003), lower blood loss (297 ± 287 vs 448 ± 670 mL, P =.03), and shorter mean length of stay (5.2 ± 7.4 vs 8.3 ± 11.7 days, P <.001), which remained significant on multivariate analysis. No differences in Pringle time, rate of postoperative complications, or R0 resections were detected. Conclusions: With appropriately selected patients treated by experienced MIS hepatopancreatobiliary surgeons, MIS resection of segments 7 or 8 is safe with similar rates of complications and R0 resections, with significantly less blood loss and shorter length of stay.

Original languageEnglish (US)
JournalJournal of Surgical Oncology
DOIs
StateAccepted/In press - 2020

Keywords

  • laparoscopic liver resection
  • liver segments 7/8
  • minimally invasive surgery liver resection
  • parenchymal sparing liver resection
  • posterior-superior liver segments

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Gholami, S., Judge, S. J., Lee, S. Y., Mashayekhi, K., Goh, B. K. P., Chan, C. Y., Nuno, M. A., Gönen, M., Balachandran, V. P., Allen, P. J., Drebin, J. A., Jarnagin, W. R., D' Angelica, M. I., & Kingham, T. P. (Accepted/In press). Is minimally invasive surgery of lesions in the right superior segments of the liver justified? A multi-institutional study of 245 patients. Journal of Surgical Oncology. https://doi.org/10.1002/jso.26154