Total abdominal approach for postero-superior segments (7, 8) in laparoscopic liver surgery: a multicentric experience

被引：21

作者：

Giuliani A. ^{[1
]}

Aldrighetti L. ^{[2
]}

Di Benedetto F. ^{[3
]}

Ettorre G.M. ^{[4
]}

Bianco P. ^{[1
]}

Ratti F. ^{[2
]}

Tarantino G. ^{[3
]}

Santoro R. ^{[4
]}

Felli E. ^{[4
]}

机构：

[1] Unit of Hepatobiliary Surgery and Liver Transplant Center, Cardarelli Hospital, Naples

[2] Hepatobiliary Surgery, Department of Surgery, San Raffaele Hospital, Milan

[3] HPB Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena

[4] Multiorgan Transplantation Program, General Surgery and Transplantation Unit, San Camillo Hospital, Rome

来源：

Updates in Surgery | 2015年 / 67卷 / 2期

关键词：

Hepatocellular carcinoma; Laparoscopic liver resection; Laparoscopic surgery; Liver colorectal metastasis; Segmentectomy;

D O I：

10.1007/s13304-015-0305-4

中图分类号：

学科分类号：

摘要：

Laparoscopic liver resections are frequently performed for peripheral lesions located in the antero-inferior segments. Resection of postero-superior segments is more demanding and dangerous than other segmentectomies, resulting in a longer operation time and increased blood loss. To reduce technical challenges, some authors advocated a modified surgical approach for these segments with the patient placed in the left lateral decubitus with the right arm suspended and suggested technical variations like the use of an additional intercostal trocar, the placement of one or two additional trans-thoracic trocars, a hand-assisted approach or a hybrid method with a median laparotomy. In the present series of 88 patients from four hepatobiliary centers with high volume of activity in Italy, a standard lithotomic position has been routinely used without the need for left lateral decubitus or semi-prone position and through abdominal wall without use of trans-thoracic trocars. This approach allows a more comfortable use of the Pringle maneuver that we used routinely in hepatic resection for PS segments; and, a very short time is needed for conversion, whenever it is required. In our series, laparoscopic resection of liver tumors located in the postero-superior segments of the liver with a total abdominal approach is technically feasible and safe with short-term results similar to other laparoscopic liver resections. © 2015, Italian Society of Surgery (SIC).

引用

页码：169 / 175

页数：6

共 40 条

[11]

Vigano L., Capussotti L., De Rosa G., De Saussure W.O., Mentha G., Rubbia-Brandt L., Liver resection for colorectal metastases after chemotherapy: impact of chemotherapy-related liver injuries, pathological tumor response, and micrometastases on long-term survival, Ann Surg, 258, pp. 731-740, (2013)

[12]

Capussotti L., Nuzzo G., Polastri R., Giuliante F., Muratore A., Giovannini I., Continuous versus intermittent portal triad clamping during hepatectomy in cirrhosis. Results of a prospective, randomized clinical trial, Hepatogastroenterology, 50, pp. 1073-1077, (2003)

[13]

Nuzzo G., Giuliante F., Giovannini I., Vellone M., De Cosmo G., Capelli G., Liver resections with or without pedicle clamping, Am J Surg, 181, pp. 238-246, (2001)

[14]

Dindo D., Demartines N., Clavien P.A., Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey, Ann Surg, 240, pp. 205-213, (2004)

[15]

Belgihiti J., Clavien P.A., Gadzijev E., Garden J.O., Lau W.Y., Makuuchi M., Strong R.W., The Brisbane 2000 terminology of liver anatomy and resections, HPB (Oxford), 2, pp. 333-339, (2000)

[16]

Zhou Y., Xiao Y., Wu L., Li B., Li H., Laparoscopic liver resection as a safe and efficacious alternative to open resection for colorectal liver metastasis: a meta-analysis, BMC Surg, 113, (2013)

[17]

Jensen L.S., Mortensen F.V., Iversen M.G., Jorgensen A., Kirkegaard P., Kehlet H., Liver surgery in Denmark 2002–2007, Ugeskr Laeger, 171, pp. 1365-1368, (2009)

[18]

Nguyen K.T., Laurent A., Dagher I., Geller D.A., Steel J., Thomas M.T., Marvin M., Ravindra K.V., Mejia A., Lainas P., Franco D., Cherqui D., Buell J.F., Gamblin T.C., Minimally invasive liver resections for metastatic colorectal cancer. A multi-institutional, international report of safety, feasibility and early outcome, Ann Surg, 250, pp. 842-848, (2009)

[19]

Schultz N.A., Larsen P.N., Klarskov B., Plum L.M., Frederiksen H.J., Christensen B.M., Kehlet H., Hillingso J.G., Evaluation of a fast-track programme for patients undergoing liver resection, Br J Surg, 100, pp. 138-143, (2013)

[20]

Cho J.Y., Han H.S., Yoon Y.S., Shin S.H., Feasibility of laparoscopic liver resection for tumours located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumour location, Surgery, 144, pp. 32-38, (2008)

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