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Resection margin in laparoscopic hepatectomy: a comparative study between wedge resection and anatomic left lateral sectionectomy.

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Resection margin in laparoscopic hepatectomy: a comparative study between wedge resection and anatomic left lateral sectionectomy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Lee, Kit-fai Wong, Jeff Cheung, Yue-sun Ip, Philip Wong, John Lai, Paul B. S.
Spatial Coverage	China
Description	Country affiliation: China Author Affiliation: Lee KF ( Division of Hepato-biliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China. leekf@surgery.cuhk.edu.hk)
Abstract	BACKGROUND: Experience from open hepatectomy shows that anatomic liver resection achieves a better resection margin than wedge resection. In recent years, laparoscopic hepatectomy has increasingly been performed in patients with liver pathology including malignant lesions. Wedge resection (WR) and left lateral sectionectomy (LLS), which also represent non-anatomic and anatomic resection respectively, are the two most common types of laparoscopic hepatectomy performed. The aim of the present study was to compare the two types of laparoscopic hepatectomy with emphasis on resection margin. METHODS: Between November 2003 and July 2009, 44 consecutive patients who underwent laparoscopic hepatectomy were identified and retrospectively reviewed. The WR and LLS group of patients were compared in terms of operative outcomes, pathological findings, recurrence patterns and survival. RESULTS: Out of the 44 patients, 21 underwent LLS and 23 a WR. The two groups of patients were comparable in demographics. The two groups did not differ in conversion rate, blood loss, blood transfusion, mortality, morbidity and post-operative length of stay. The LLS group patients had significantly larger liver lesions, wider resection margin and less sub-centimetre margins. In patients with malignant liver lesions, there was no difference between the two groups in incidence of intra-hepatic recurrence and 3-year overall and disease-free survival. CONCLUSION: Operative outcomes are similar between laparoscopic WR and LLS. However, WR is less reliable than LLS in achieving a resection margin of more than 1 cm. Larger studies involving more patients with longer follow-up are warranted to determine the impact of the resection margin on intra-hepatic recurrence and survival.
File Format	HTM / HTML
ISSN	1365182X
e-ISSN	14772574
DOI	10.1111/j.1477-2574.2010.00221.x
Journal	HPB
Issue Number	9
Volume Number	12
Language	English
Publisher	Elsevier
Publisher Date	2010-11-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Gastroenterology Hepatectomy Laparoscopy Liver Neoplasms Surgery Blood Transfusion Chi-square Distribution Disease-free Survival Adverse Effects Mortality Kaplan-meier Estimate Length Of Stay Pathology Neoplasm Recurrence, Local Retrospective Studies Risk Assessment Risk Factors Survival Rate Time Factors Comparative Study
Content Type	Text
Resource Type	Article
Subject	Hepatology Gastroenterology

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