Pure Laparoscopic Major Liver Resection After Yttrium Radioembolization: a Case-matched Series Analysis of Feasibility and Outcomes

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2022 Mar 1

PMID 35229168

Authors

Daniel Aliseda

Pablo Marti-Cruchaga

Gabriel Zozaya

Alberto Benito

Luis Lopez-Olaondo

Macarena Rodriguez-Fraile

Jose I Bilbao

Francisco Hidalgo

Mercedes Inarrairaegui

Ruben Ciria

Fernando Pardo

Bruno Sangro

Fernando Rotellar

Affiliations

Soon will be listed here.

Abstract

Background: Liver surgery after radioembolization (RE) entails highly demanding and challenging procedures due to the frequent combination of large tumors, severe RE-related adhesions, and the necessity of conducting major hepatectomies. Laparoscopic liver resection (LLR) and its associated advantages could provide benefits, as yet unreported, to these patients. The current study evaluated feasibility, morbidity, mortality, and survival outcomes for major laparoscopic liver resection after radioembolization.

Material And Methods: In this retrospective, single-center study patients diagnosed with hepatocellular carcinoma, intrahepatic cholangiocarcinoma or metastases from colorectal cancer undergoing major laparoscopic hepatectomy after RE were identified from institutional databases. They were matched (1:2) on several pre-operative characteristics to a group of patients that underwent major LLR for the same malignancies during the same period but without previous RE.

Results: From March 2011 to November 2020, 9 patients underwent a major LLR after RE. No differences were observed in intraoperative blood loss (50 vs. 150 ml; p = 0.621), operative time (478 vs. 407 min; p = 0.135) or pedicle clamping time (90.5 vs 74 min; p = 0.133) between the post-RE LLR and the matched group. Similarly, no differences were observed on hospital stay (median 3 vs. 4 days; p = 0.300), Clavien-Dindo ≥ III complications (2 vs. 1 cases; p = 0.250), specific liver morbidity (1 vs. 1 case p = 1.000), or 90 day mortality (0 vs. 0; p = 1.000).

Conclusion: The laparoscopic approach for post radioembolization patients may be a feasible and safe procedure with excellent surgical and oncological outcomes and meets the current standards for laparoscopic liver resections. Further studies with larger series are needed to confirm the results herein presented.

Citing Articles

Liver Resection and Transplantation Following Yttrium-90 Radioembolization for Primary Malignant Liver Tumors: A 15-Year Single-Center Experience.

Aliseda D, Marti-Cruchaga P, Zozaya G, Rodriguez-Fraile M, Bilbao J, Benito-Boillos A Cancers (Basel). 2023; 15(3).

PMID: 36765691 PMC: 9913597. DOI: 10.3390/cancers15030733.

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