Abstract
BackgroundLiver 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 methodsIn 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.ResultsFrom 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).ConclusionThe 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.
Highlights
Radioembolization (RE), known as selective internal radiation therapy, is a liver-directed therapy that is based on transarterial delivery of high-dose beta radiation to the tumor-associated capillaries, thereby sparing healthy liverPart of this material was presented during the 2nd SIR-Spheres® User Meeting in Frankfurt, Germany. 21st February 2020Extended author information available on the last page of the article tissue [1]
For patients with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), the published literature has shown that RE produces clinically significant reductions in tumor size leading to a downstaging that may allow, in some cases, access to a surgical approach with curative intent [2, 3]
It has been reported that RE combined with chemotherapy may be a rescue procedure for initially unresectable colorectal liver metastases (CRLM), making them resectable in some selected cases [4]
Summary
Radioembolization (RE), known as selective internal radiation therapy, is a liver-directed therapy that is based on transarterial delivery of high-dose beta radiation to the tumor-associated capillaries, thereby sparing healthy liverPart of this material was presented during the 2nd SIR-Spheres® User Meeting in Frankfurt, Germany. 21st February 2020Extended author information available on the last page of the article tissue [1]. Radioembolization (RE), known as selective internal radiation therapy, is a liver-directed therapy that is based on transarterial delivery of high-dose beta radiation to the tumor-associated capillaries, thereby sparing healthy liver Part of this material was presented during the 2nd SIR-Spheres® User Meeting in Frankfurt, Germany. 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. Further studies with larger series are needed to confirm the results presented
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
