학술논문

Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes.
Document Type
Article
Source
Surgical Endoscopy & Other Interventional Techniques. Jun2013, Vol. 27 Issue 6, p1881-1886. 6p. 5 Charts, 1 Graph.
Subject
*LAPAROSCOPIC surgery
*SURGICAL excision
*LIVER surgery
*PRIMARY care
*LIVER cancer
*FEASIBILITY studies
*HEALTH outcome assessment
Language
ISSN
1866-6817
Abstract
Background: Standard oncologic liver resections performed on elderly patients (≥70 years old) have been shown to be safe and effective. The aim of this study was to analyze operative and oncologic short-term outcomes of totally laparoscopic liver resections (TLLR) performed on elderly patients for malignancies. Methods: We performed a retrospective statistical analysis of prospectively recorded data of TLLR performed from October 2008 to February 2012 by a single hepato-pancreato-biliary (HPB) surgeon. Patients were divided into two groups according to age (<70 vs. ≥70 years old) and perioperative outcomes were compared. Result: A total of 60 TLLR for malignancies were identified of which 25 patients (42 %) were aged ≥70 years (Group A) and 35 (58 %) were aged <70 years (Group B). There was no difference in operative time (170 vs. 180 min, p = 0.267), median blood loss (200 vs. 250 ml, p = 0.183), number and time of Pringle maneuver ( p = 0.563 and p = 0.180), blood transfusion rate (4 vs. 17 %, p = 0.222), conversion rate (4 vs. 9 %, p = 0.443), morbidity rate (12 vs. 20 %, p = 0.797), and perioperative mortality rate (0 vs. 3 %, p = 0.688). An R0 resection was achieved in 92 (Group A) versus 83 % (Group B) ( p = 0.265). At a median follow-up of 18 months, 12 % of patients in Group A experienced a disease recurrence with a related mortality rate similar to that of Group B (8 vs. 12 %, p = 0.375). Conclusion: This retrospective comparative study shows that TLLR performed on elderly for liver neoplasm are feasible and safe and lead to short-term outcomes similar to those of younger patients. [ABSTRACT FROM AUTHOR]

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