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Protective benefit of minimally invasive liver surgery for hepatocellular carcinoma prior to transplant

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Hepatoma Research 2022年第1期8卷 179-187页

作者： Simone Khouzam Duilio Pagano Marco Barbara Vito Di Marco Giada Pietrosi Marco Maringhini Marco Canzonieri Sergio Calamia Salvatore Gruttadauria Sidney Kimmel Medical College Thomas Jefferson UniversityPhiladelphiaPA 19107USA Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation IRCCS-ISMETT(Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per I Trapianti e Terapie ad Alta Specializzazione)UPMC(University of Pittsburgh Medical Center)via E.Tricomi 5Palermo 90127Italy Sezione di Gastroenterologia e Epatologia Dipartimento Biomedico di Medicina Interna e SpecialisticaUniversity of PalermoPalermo 90128Italy Medicina Interna Universitàdi Palermo/ISMETTVia del Vespro 129Palermo 90127Italy Department of surgery and Medical and Surgical Specialties University of CataniaCatania 95124Italy

Aim:The purpose of this study is to assess the benefit of laparoscopic liver resection(LLR)for hepatocellular carcinoma(HCC)given recurrence and future need for liver transplantation(LT).Methods:Data on liver resections were gathered from the Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per i Trapianti e Terapie ad alta specializzazione(IRCCS-ISMETT)from 2003-2021.A retrospective analysis of 1408 consecutive adult patients who had a liver resection was performed with categorization based on the underlying disease process.A sub-analysis studied the 291 patients who had an LLR with an intention to transplant approach after ***:From 2012 to 2020,ISMETT’s mean annual LLR rate was 45%.Data suggests that a laparoscopic approach to iterative surgical treatment for HCC has demonstrated protective *** to open surgery or LT,LLR is protective against the risk of de-listing,post-transplant patient death,tumor recurrence,adhesions,and bleeding in a cirrhotic *** Meier’s analysis showed no difference between post-LT survival curves for those with prior open abdominal surgery or LLR(P=0.658).Conclusion:Laparoscopic surgery has important protective advantages over laparotomy surgery for the surgical treatment of HCC,particularly since treatment is not always *** can be considered a bridge therapy for transplantation,ensuring less crowding of waiting lists,a desirable condition in areas of donor storage.

关键词： Laparoscopic liver resection hepatocellular carcinoma minimally invasive liver surgery

A narrative review of the current and future role of robotic surgery in liver surgery and transplantation

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Hepatobiliary surgery and Nutrition 2023年第1期12卷 56-68页

作者： Michele Finotti Francesco D’Amico David Mulligan Giuliano Testa Simmons Transplant Institute Baylor University Medical CenterDallasTXUSA Transplantation and Hepatobiliary surgery University of PadovaPadovaItaly Department of surgery Yale University School of MedicineNew HavenCTUSA

Background:minimally invasive surgery(MIS)is the technique of choice in selected patients for the treatment of liver *** robotic approach is considered today the natural evolution of *** application of the robotic technique in liver transplantation(LT)has been recently evaluated,especially in the living *** aim of this paper is to review the current role of the MIS and robotic donor hepatectomy in the literature and to evaluate the possible future implication in the transplant ***:We conducted a narrative review using PubMed and Google Scholar for reports published so far,using the following keywords:minimally invasive liver surgery,laparoscopic liver surgery,robotic liver surgery,robotic living donation,laparoscopic donor hepatectomy and robotic donor ***:Several advantages have been claimed in favor of robotic surgery:three-dimensional(3-D)imaging with stable and high-definition view;a more rapid learning curve than the laparoscopic one;the lack of hand tremors and the freedom of *** to open surgery,the benefits showed in the studies evaluating the robotic approach in the living donation are:less postoperative pain,the shorter period before returning to normal activity despite sustaining longer operation ***,the 3-D and magnification view makes the technique excellent in distinguishing the right plane of transection,vascular and biliary anatomy,associated with high precision of the movements and a better bleeding control(essential for donor safety)and lower rate of vascular ***:The current literature does not fully support the superiority of the robotic approach versus laparoscopic or open method in living donor *** donor hepatectomy performed by teams with high expertise and in properly selected living donors is safe and ***,further data are necessary to evaluate properly the role of robotic surgery in the field of living donation.

关键词： minimally invasive liver surgery robotic living donation laparoscopic donor hepatectomy robotic donor hepatectomy

Difficult procedures,better outcomes

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Hepatobiliary surgery and Nutrition 2023年第4期12卷 634-636页

作者： Davit L.Aghayan Airazat M.Kazaryan Asmund Avdem Fretland Bjorn Edwin The Intervention Centre Oslo University Hospital-RikshospitaletOsloNorway Department of surgery N1 Yerevan State Medical University after M.HeratsiYerevanArmenia Institute of Clinical Medicine Medical FacultyUniversity of OsloOsloNorway Department of Gastrointestinal and Pediatric surgery Oslo University Hospital-UllevålOsloNorway Department of surgery Østfold Hospital TrustGrålumNorway Department of Faculty surgery N 2 I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Department of surgery Fonna Hospital TrustOddaNorway Department of HPB surgery Oslo University Hospital-RikshospitaletOsloNorway

Despite the initial skepticism and challenges,minimally invasive liver surgery especially laparoscopic liver resections(LLR),has become a first-choice surgical treatment for various liver tumors in many specialized centers worldwide(1-3).It is a safe alternative to open surgery thanks to advantages such as reduced blood loss and complication rates,shorter hospital stay,and better quality of life(4-7).However,laparoscopy requires relatively long learning,and complex procedures are limited to high-volume expert centers(8).

关键词： liver resection laparoscopic liver surgery minimally invasive liver surgery complex procedures

The efforts are worth the benefits for laparoscopic liver resection

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Hepatobiliary surgery and Nutrition 2023年第5期12卷 813-814页

作者： Edward Willems Mathieu D’Hondt Department of Digestive and Hepatobiliary/Pancreatic surgery Groeninge HospitalKortrijkBelgium

Last year,Hepatobiliary surgery and Nutrition published an interesting analysis performed by Ratti and colleagues(1).This study aimed to understand if the efforts associated with the laparoscopic approach in liver surgery are always worthwhile,specifically in high-complexity *** endpoint was to analyse the degree of benefit of laparoscopy over open liver surgery(OLS)in different levels of technical *** endpoint was to confirm that advantages of minimally invasive techniques over open are detectable within all levels of complexity.

关键词： Laparoscopic liver surgery(LLS) minimally invasive liver surgery learning curve differential benefit

The role of minimally invasive surgery in the treatment of HCC

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Hepatoma Research 2022年第1期8卷 301-312页

作者： Gianluca Cassese Ho-Seong Han Boram Lee Hae Won Lee Jai Young Cho Roberto Ivan Troisi Department of HPB surgery Seoul National University Bundang HospitalSeongnam-si 13620South Korea Department of Clinical Medicine and surgery Minimally invasive and robotic HPB Surgery UnitFederico II UniversityNaples 80131Italy

liver surgery is the first-line treatment for hepatocellular carcinoma(HCC).minimally invasive liver resection(MILS)has become an attractive option thanks to reduced intraoperative blood losses,shortened length of hospital stay,and similar oncological outcomes when compared to open liver ***,the safety of MILS is still debated in challenging situations,such as in cirrhotic patients,difficult tumor locations,multiple or large tumors,and repeat *** aim of this review is to discuss current indications of laparoscopic liver resection for HCC treatment in the light of its outcomes,focusing on technical aspects of minimally invasive anatomic liver resection and state of the art of MILS in challenging situations.

关键词： Laparoscopic liver resection hepatocellular carcinoma minimally invasive liver surgery anatomic liver resection