Combination of liver resection and polychemotherapy is the most effective method for treating malignant liver tumors. Liver resections can be performed laparoscopically.
OBJECTIVE
To summarize the experience of performing laparoscopic liver resections (LLR) in an oncology clinic.
MATERIAL AND METHODS
From 2019 to 2024, 100 LLR procedures were performed at Oncology Department No. 4 of the S.S. Yudin City Clinical Hospital. Indications for surgery included: oligometastases of colorectal cancer in 69 (69%) patients, primary liver tumors in 13 (13%), metastases from non-colorectal cancers in 9 (9%), gallbladder cancer in 4 (4%), benign tumors in 5 (5%).
RESULTS
Atypical liver resections were performed in 67 (67%) cases, anatomical resections in 17 (17%), hemihepatectomies in 6 (6%), and ALPPS hemihepatectomies in 6 cases. LLR was carried out with removal of the primary tumor in 13 (13%) patients, with stoma closure in 6 (6%), with lung resection in 2 (2%), and with retroperitoneal lymphadenectomy in 1 (1%) patient. According to Kawaguchi’s classification of surgical difficulty for LLR, the median duration of first-degree complexity procedures was 180 minutes (range: 50—470), for second degree — 325 minutes (range: 190—370), and for third degree — 290 minutes (range: 130—470). The median blood loss for first-degree complexity procedures was 200 ml (range: 20—700), for second degree — 300 ml (range: 20—1000), and for third degree — 300 ml (range: 40—1200). Conversion to open surgery was performed in 10 (10%) patients.
Complications developed in 19 (19%) patients, among which severe complications occurred in 14 (14%). The mortality rate was 2%. The complexity of LLR was a significant predictor of postoperative complications (OR=4.84; 95% CI: 1.71—50.9; p=0.009).
CONCLUSION
Liver resection can be effectively performed laparoscopically. The frequency and severity of complications, as well as operative duration and blood loss, depend on the complexity of the procedure.
