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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Masuda, Takashi Endo, Yuichi Amano, Shota Kawamura, Masahiro Fujinaga, Atsuro Kawasaki, Takahide Kawano, Yoko Hirashita, Teijiro Ohta, Masayuki Inomata, Masafumi |
| Abstract | Background Laparoscopic repeat hepatectomy (LRH) has increased, but appropriate indications for LRH are unclear. This study aimed to clarify appropriate indications for LRH. Methods We retrospectively compared surgical outcomes between open RH (ORH) (n = 57) and LRH (n = 40) groups. To detect difficult cases of complete pure LRH, we examined patients with unplanned intraoperative hand-assisted laparoscopic surgery (HALS)/open conversion (n = 6). Results In the LRH versus ORH group, as previous hepatectomy, laparoscopic (75% vs. 12%, p < 0.001) and partial hepatectomy (Hr0) (73% vs. 37%, p = 0.002) were more frequently performed, and as RH procedure, partial hepatectomy (Hr0) (88% vs. 47%, p = 0.0002) was more frequently performed. S1 tumor cases were higher in ORH group (11% vs. 0%), but S2-6 cases were higher in LRH group (73% vs. 49%) (p = 0.02). In LRH group, compared to the pure LRH patients, HALS/open conversion patients underwent significantly more previous hepatectomy with more than lobectomy (Hr2-3) (33% vs. 2.9%, p = 0.033) and more RH procedures with segmentectomy (HrS) (33% vs. 2.9%, p = 0.03). All LRH requiring a repeat hepatic hilar approach were HALS conversions. Conclusion Appropriate indications for LRH were previous hepatectomy was laparoscopic partial hepatectomy (Hr0), and RH procedure was partial hepatectomy (Hr0) for S2-6 tumor location. When RH is more than segmentectomy (HrS) requiring a repeat hepatic hilar approach, planned HALS or ORH may be a better approach than pure LRH. |
| Related Links | https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-023-02208-y.pdf |
| Ending Page | 7 |
| Page Count | 7 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14712482 |
| DOI | 10.1186/s12893-023-02208-y |
| Journal | BMC Surgery |
| Issue Number | 1 |
| Volume Number | 23 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-10-24 |
| Access Restriction | Open |
| Subject Keyword | Surgery Internal Medicine Laparoscopic repeat hepatectomy Repeat hepatectomy Conversion HALS Difficulty score |
| Content Type | Text |
| Resource Type | Article |
| Subject | Surgery |
| Journal Impact Factor | 1.6/2023 |
| 5-Year Journal Impact Factor | 1.9/2023 |
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