Radiofrequency-assisted liver resections: comparison of open and laparoscopic techniques.

Abstract

After the first reported laparoscopic liver resection (LLR) twenty years ago, liver surgery still remains one of the last areas of resistance to the offensive of laparoscopy. Radiofrequency assisted laparoscopic liver resection has been recently developed technique for treatment of primary and secondary liver tumors. Over a 5-year period, a total of 134 laparoscopic and open radiofrequency assisted operations were performed in a single institution. LLR was done in 47 patients, and open liver resection (OLR) in 87 patients. The study selection criteria were fulfilled by 134 patients. The mean blood loss for LLR was 68.7 mL, the difference between the groups was significant with lower median of blood loss using laparoscopy (p=0.046). The mean of length of hospital stay in LLR was 7.5 days versus 8.7 days in OLR (p=0.071). The 5-year survival rate was 67.0% after LLR and 63.8% after OLR. The 5-year disease-free survival rate was 59.4% after LLR, and 62.2% after OLR. The difference between groups was not statistically significant. Laparoscopic liver resection is safe and feasible procedure. The hand-assisted laparoscopic radiofrequency technique can be applied effectively for selected patients. Preliminary oncological results suggest non-inferiority of laparoscopic to open procedures.