Segmentectomy: is minimally invasive surgery going to change a liver dogma?

Fulvio Calise, Antonio Giuliani, Loredana Sodano, Enrico Crolla, Paolo Bianco, Aldo Rocca, Antonio Ceriello

Research output: Contribution to journalArticle

Abstract

Nowadays, the respective approach to hepatic resections (for malignant or benign liver lesions) is oriented toward minimal parenchymal resection. This surgical behavior is sustained by several observations that surgical margin width is not correlated with recurrence of malignancies. Parenchymal-sparing resection reduces morbidity without changing long-term results and allows the possibility of re-do liver resection in case of recurrence. Minimally invasive liver surgery (MILS) is performed worldwide and is considered a standard of care for many surgical procedures. MILS is associated with less blood loss, less analgesic requirements, and shorter length of hospital with a better quality of life. One of the more frequent criticisms to MILS is that it represents a more challenging approach for anatomical segmentectomies and that in most cases a non-anatomical resection could be performed with thinner resection margins compared with open surgery. But even in the presence of reduced surgical margins, oncological results in the short- and long-term follow-up seem to be the same such as open surgery. The purpose of this review is to try to understand whether chasing at any cost laparoscopic anatomical segmentectomies is still necessary whereas non-anatomical resections, with a parenchymal-sparing behavior, are feasible and overall recommended also in a laparoscopic approach. The message coming from this review is that MILS is opening more and more new frontiers that are still need to be supported by further experience.

Original languageEnglish
Pages (from-to)111-115
Number of pages5
JournalUpdates in Surgery
Volume67
Issue number2
DOIs
Publication statusPublished - Jun 1 2015

Keywords

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

ASJC Scopus subject areas

  • Surgery

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