Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

Andrea Ruzzenente, Andrea Ciangherotti, Luca Aldrighetti, Giuseppe Maria Ettorre, Luciano De Carlis, Alessandro Ferrero, Raffaele Dalla Valle, Giuseppe Tisone, Alfredo Guglielmi, Francesca Ratti, Enrico Gringeri, Nadia Russolillo, Tommaso Campagnaro, Simone Conci, Giovanni Battista. Levi Sandri, Francesco Ardito, Ugo Boggi, Salvatore Gruttadauria, Luca Viganò, Fabrizio Di BenedettoGiogio Ettore. Rossi, Stefano Berti, Graziano Ceccarelli, Leonardo Vincenti, Umberto Cillo, Felice Giuliante, Vincenzo Mazzaferro, Elio Jovine, Fulvio Calise, Giulio Belli, Fausto Zamboni, Andrea Coratti, Pietro Mezzatesta, Roberto Santambrogio, Giuseppe Navarra, Fabio Ferla, Antonio Domenico. Pinna, Amilcare Parisi, Michele Colledan, Abdallah Slim, Adelmo Antonucci, Gian Luca Grazi, Antonio Frena, Giovanni Sgroi, Alberto Brolese, Luca Morelli, Antonio Floridi, Alberto Patriti, Luigi Veneroni, Luigi Boni, Piero Maida, Guido Griseri, Marco Filauro, Silvio Guerriero, Raffaele Romito, Umberto Tedeschi, Giuseppe Zimmitti

Research output: Contribution to journalMeeting Abstractpeer-review

Abstract

Background: Although isolated caudate lobe (CL) liver resection is not a contraindication for minimally invasive liver surgery (MILS), feasibility and safety of the procedure are still poorly investigated. To address this gap, we evaluate data on the Italian prospective maintained database on laparoscopic liver surgery (IgoMILS) and compare outcomes between MILS and open group. Methods: Perioperative data of patients with malignancies, as colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), non-colorectal liver metastases (NCRLM) and benign liver disease, were retrospectively analyzed. A propensity score matching (PSM) analysis was performed to balance the potential selection bias for MILS and open group. Results: A total of 224 patients were included in the study, 47 and 177 patients underwent MILS and open isolated CL resection, respectively. The overall complication rate was comparable between the two groups; however, severe complication rate (Dindo–Clavien grade ≥ 3) was lower in the MILS group (0% versus 6.8%, P = ns). In-hospital mortality was 0% in both groups and mean hospital stay was significantly shorter in the MILS group (P = 0.01). After selection of 42 MILS and 43 open CL resections by PSM analysis, intraoperative and postoperative outcomes remained similar except for the hospital stay which was not significantly shorter in MILS group. Conclusions: This multi-institutional cohort study shows that MILS CL resection is feasible and safe. The surgical procedure can be technically demanding compared to open resection, whereas good perioperative outcomes can be achieved in highly selected patients.
Original languageEnglish
Pages (from-to)1490-1499
Number of pages10
JournalSurgical Endoscopy
Volume36
DOIs
Publication statusPublished - 2021

Keywords

  • Caudate lobe
  • Minimally invasive liver surgery
  • Multi-institutional
  • Propensity score matched

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