Laparoscopic repeat liver resection after open liver resection is safe and feasible compared with laparoscopic primary liver resection: a comparative study from a single center

Abstract

Background: Technological innovations and accumulating experience have made it possible to use laparoscopic liver resection cases with re-existing adhesions or cicatricial changes. This study aimed to clarify the outcomes of laparoscopic repeat liver resection (LRLR) among cases of recurrent liver cancer after open liver resection. Methods: There were 157 patients who underwent laparoscopic liver resection for liver tumors at our institution during September 2012-September 2016. Sixty-two patients were included in analysis and were retrospectively divided into an LRLR group (n = 13) and a laparoscopic primary liver resection group (LPLR; n = 49), and the groups were compared in term of patient demographics, surgical procedures, and short-term surgical outcomes. Recurrence-free survival and overall survival were compared for patients with hepatocellular carcinoma and with colorectal liver metastases. Results: There was a significant inter-group difference in the hepatitis virus background (p= 0.036), but other patient demographics were comparable between the two groups. The two groups had similar values for extent of resection, operative time, estimated blood loss, transfusion requirement, conversion to laparotomy, postoperative complications, surgical margins, time to oral intake, and hospital stay. Furthermore, there were no inter-group differences in recurrence-free or overall survival in the LRLR and LPLR groups when we compared patients with hepatocellular carcinoma and patients with colorectal liver metastases. Conclusion: The LRLR and LPLR groups had equivalent short-term outcomes. Furthermore, LRLR does not compromise oncological outcomes compared to LPLR.