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Special Issue
Advances in Minimally Invasive Cirrhotic Surgery
Guest Editor:
Giulio Belli, MD
General and HPB Surgery,
Loreto Nuovo Hospital,
80121 Naples, Italy.
Email: giubelli@unina.it
Special Issue Introduction
Hepatocellular carcinoma (HCC) is the sixth most common type of
cancer worldwide and the third leading cause of cancer-related
death. It is the most common primary liver cancer and its incidence
increases when associated with the development of cirrhosis. Liver
resection is a curative therapy, when liver transplantation due to the
patient age and alcohol abuse, associated diseases, and shortage of
donors, is not feasible. During the last decades, progress in
preoperative patient assessment, renement of the indications for
resection, improved surgical technique, and the development of new
surgical devices have greatly enhanced the safety of open
hepatectomy in normal and even in cirrhotic liver. In fact, the role of
the mininvasive approach in liver surgery continues to increase, and
many types of liver resections, even in cirrhotic liver, including major
hepatectomies, are now performed laparoscopically in specialized
centers. It is now clear that laparoscopic liver resection for HCC on
cirrhotic liver has better short results when compared to an open
approach. In fact, despite its technical challenges, reduced operative
blood loss, fewer early postoperative complications, such as
postoperative ascites, lower analgesic drug requirements, and shorter
hospital stay are the clear advantages of the laparoscopic approach.
Therefore, laparoscopic resection of HCC in cirrhotic liver is not only
feasible and safe in selected patients with excellent short-term results,
but achieves not inferior long-term survival end recurrence rates
compared with open surgery when stratied for tumor characteristics
known to be related to survival of outcome.
In this special issue of Hepatoma Research focusing on “Advances in
Minimally Invasive Cirrhotic Surgery”, the challenges of this rapidly
developing eld are addressed. Each of the contributors has referred
specic aspects of their experienced area, discussing its limits but also
its advantages. They have also discussed their technique and results.
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