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Kilburn et al. Laparoscopic resection of HCC

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hepatic volume in the setting of cirrhosis. In our series, 4. Altekruse SF, Henley SJ, Cucinelli JE, McGlynn KA. Changing
we had 8 dome lesions. During our early experience, hepatocellular carcinoma incidence and liver cancer mortality rates in
we approached a segment 8 dome lesion with a hand- the United States. Am J Gastroenterol 2014;109:542-53.
assisted technique. Adequate margins could not be 5. Lau WY. Management of hepatocellular carcinoma. J R Coll Surg
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subsequently modified our technique to use intercostal 6. Lai EC, Lau WY. The continuing challenge of hepatic cancer in Asia.
and transthoracic trocars (ITT) for such lesions. We 7. Surgeon 2005;3:210-5.
Gigot JF, Glineur D, Santiago Azagra J, Goergen M, Ceuterick M,
found that the ITT approach offered better visualization, Morino M, Etienne J, Marescaux J, Mutter D, van Krunckelsven L,
access for resection and ability to control hemorrhage Descottes B, Valleix D, Lachachi F, Bertrand C, Mansvelt B, Hubens G,
compared with the hand-assisted technique. Saey JP, Schockmel R; Hepatobiliary, Pancreatic Section of the Royal
Belgian Society of Surgery; the Belgian Group for Endoscopic Surgery.
This study is limited by its retrospective nature. We Laparoscopic liver resection for malignant liver tumors: preliminary
showed that laparoscopic resection is feasible and results of a multicenter European study. Ann Surg 2002;236:90-7.
safe, but without an open comparison group, the true 8. Tang CN, Li MK. Laparoscopic-assisted liver resection. J Hepatobiliary
Pancreat Surg 2002;9:105-10.
perioperative benefits are unclear. The long-term 9. Gagner M, Rogula T, Selzer D. Laparoscopic liver resection: benefits
recurrence and survival outcomes in our cohort need and controversies. Surg Clin North Am 2004;84:451-62.
to be further investigated in order to further define 10. Cherqui D, Laurent A, Tayar C, Chang S, Van Nhieu JT, Loriau J, Karoui
the oncological equivalence of laparoscopic resection M, Duvoux C, Dhumeaux D, Fagniez PL. Laparoscopic liver resection
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disease: midterm results and perspectives. Ann Surg 2006;243:499-506.
In conclusion, laparoscopic liver resection for 11. Tang CN, Tsui KK, Ha JP, Yang GP, Li MK. A single-centre experience
of 40 laparoscopic liver resections. Hong Kong Med J 2006;12:419-25.
hepatocellular carcinoma can be performed with 12. Dagher I, Lainas P, Carloni A, Caillard C, Champault A, Smadja C,
acceptable morbidity and adequate surgical margins. Franco D. Laparoscopic liver resection for hepatocellular carcinoma.
The technical challenges of liver resection are often Surg Endosc 2008;22:372-8.
magnified with laparoscopy, particularly in patients with 13. Li N, Wu YR, Wu B, Lu MQ. Surgical and oncologic outcomes
cirrhosis. However, such difficulties can be overcome following laparoscopic versus open liver resection for hepatocellular
with increasing experience. We believe that the carcinoma: a meta-analysis. Hepatol Res 2012;42:51-9.
benefits of a minimally invasive approach are also more 14. Shimada M, Hashizume M, Maehara S, Tsujita E, Rikimaru T, Yamashita
pronounced in cirrhotics, due to the potential to reduce Y, Tanaka S, Adachi E, Sugimachi K. Laparoscopic hepatectomy for
hepatocellular carcinoma. Surg Endosc 2001;15:541-4.
morbidity compared to an open approach. Future 15. Belli G, Fantini C, D’Agostino A, Belli A, Langella S. Laparoscopic
studies comparing laparoscopic to open resection with hepatic resection for completely exophytic hepatocellular carcinoma on
long-term follow-up should be performed to further cirrhosis. J Hepatobiliary Pancreat Surg 2005;12:488-93.
define its role. 16. Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T,
Maeda T, Shiba T. Laparoscopic liver resection of hepatocellular
Financial support and sponsorship carcinoma. Am J Surg 2005;189:190-4.
None. 17. Belli G, Fantini C, Belli A, Limongelli P. Laparoscopic liver resection
for hepatocellular carcinoma in cirrhosis: long-term outcomes. Dig
Surg 2011;28:134-40.
Conflicts of interest 18. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I,
There are no conflicts of interest. Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G,
Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P,
Patient consent Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D,
Necessary consent was obtained. Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie
J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M,
Ethics approval Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J,
Approved by an institutional board at Royal Brisbane Strasberg S, Chari RS; World Consensus Conference on Laparoscopic
Surgery. The international position on laparoscopic liver surgery: the
Hospital. Louisville Statement, 2008. Ann Surg 2009;250:825-30.
19. Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic
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