Is Laparoscopic Hepatectomy Safe for Giant Liver Tumors? Proposal from a Single Institution for Totally Laparoscopic Hemihepatectomy Using an Anterior Approach for Giant Liver Tumors Larger Than 10 cm in Diameter

腹腔镜肝切除术治疗巨大肝肿瘤安全吗?一家机构提出的采用前入路行全腹腔镜半肝切除术治疗直径大于10厘米的巨大肝肿瘤的方案

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Abstract

BACKGROUND: The efficacy and safety of laparoscopic liver resections for liver tumors that are larger than 10 cm remain unclear. We developed a safe laparoscopic right hemihepatectomy for giant liver tumors using an anterior approach. METHODS: Eighty patients who underwent laparoscopic hemihepatectomy between January 2011 and December 2021 were divided into a nongiant tumor group (n = 65) and a giant tumor group (n = 15) for comparison. RESULTS: The median operating time, amount of blood loss, and length of postoperative hospital stay did not differ significantly between the nongiant and giant tumor groups. The sizes of the tumors and weights of the resected liver were significantly larger in the giant tumor group. A comparison between a nongiant group (n = 23) and a giant group (n = 12) treated with laparoscopic right hemihepatectomy showed similar results. CONCLUSIONS: Laparoscopic hemihepatectomy, especially that performed on the right side, for giant tumors larger than 10 cm can be performed safely. Surgical techniques for giant liver tumors have been standardized, and their application is expected to spread widely in the future.

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