Laparoscopic and robotic radical surgery for liver alveolar echinococcosis (echinococcus multilocularis).
EAES Academy. Elizarova N. 07/05/22; 366539; P282
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Abstract
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Aim. To estimate the immediate and long-term results of laparoscopic and robotic radical surgery for liver alveolar echinococcosis (AE).
Methods. From 2013 to 2019, at the Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific Centre 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da’Vinci robotic complex was used. In all cases a mass was found in the right lobe of the liver, mainly 7-8 liver segments. The average lesion size was 60±20 mm.
Results. In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1: 1). In 2 cases patients had previous abdominal surgery. The mean operation time was 344±141 minutes, the average blood loss was 350±333 ml. An intermittent Pringle maneuvre was used in 4 cases (66,7%) with average ligament clamping time 19 minutes and with pauses of at least 5 minutes. Complications were observed in one case (16,7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9±3. In all cases, there was histological confirmation of the diagnosis by the results of a study of a remote lesion. The average observation time was 45,4 months (10-84).
Conclusion. Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.
Methods. From 2013 to 2019, at the Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific Centre 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da’Vinci robotic complex was used. In all cases a mass was found in the right lobe of the liver, mainly 7-8 liver segments. The average lesion size was 60±20 mm.
Results. In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1: 1). In 2 cases patients had previous abdominal surgery. The mean operation time was 344±141 minutes, the average blood loss was 350±333 ml. An intermittent Pringle maneuvre was used in 4 cases (66,7%) with average ligament clamping time 19 minutes and with pauses of at least 5 minutes. Complications were observed in one case (16,7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9±3. In all cases, there was histological confirmation of the diagnosis by the results of a study of a remote lesion. The average observation time was 45,4 months (10-84).
Conclusion. Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.
Aim. To estimate the immediate and long-term results of laparoscopic and robotic radical surgery for liver alveolar echinococcosis (AE).
Methods. From 2013 to 2019, at the Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific Centre 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da’Vinci robotic complex was used. In all cases a mass was found in the right lobe of the liver, mainly 7-8 liver segments. The average lesion size was 60±20 mm.
Results. In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1: 1). In 2 cases patients had previous abdominal surgery. The mean operation time was 344±141 minutes, the average blood loss was 350±333 ml. An intermittent Pringle maneuvre was used in 4 cases (66,7%) with average ligament clamping time 19 minutes and with pauses of at least 5 minutes. Complications were observed in one case (16,7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9±3. In all cases, there was histological confirmation of the diagnosis by the results of a study of a remote lesion. The average observation time was 45,4 months (10-84).
Conclusion. Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.
Methods. From 2013 to 2019, at the Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific Centre 6 patients with AE were undergone radically surgery using minimally invasive technologies. In 5 cases, a laparoscopic liver resection was performed, and in one case a Da’Vinci robotic complex was used. In all cases a mass was found in the right lobe of the liver, mainly 7-8 liver segments. The average lesion size was 60±20 mm.
Results. In three cases (50%) patients with P2 stage of the disease were operated on, in 3 cases with P1. In two cases, in patients with stage P2, a right hemihepatectomy was performed, in 2 cases a segmentectomy 8 with atypical resection segment 4 was performed, in one case a posterior sectionectomy was performed, in one case the intervention was performed with atypical resection of 6 segments. The average age of the patients was 55 years (27-79), three women and three men (1: 1). In 2 cases patients had previous abdominal surgery. The mean operation time was 344±141 minutes, the average blood loss was 350±333 ml. An intermittent Pringle maneuvre was used in 4 cases (66,7%) with average ligament clamping time 19 minutes and with pauses of at least 5 minutes. Complications were observed in one case (16,7%), type II according to Clavien-Dindo, represented by dynamic intestinal obstruction, which developed on the 6th day of the postoperative period and was resolved conservatively. Mean hospital stay was 9±3. In all cases, there was histological confirmation of the diagnosis by the results of a study of a remote lesion. The average observation time was 45,4 months (10-84).
Conclusion. Laparoscopic and robotic liver resections in the radical treatment of alveococcosis can be safe and feasible in the early stages of alveococcosis (P1-2H0M0), provided they are performed in a specialized hospital with sufficient technical equipment and an experienced surgeon.
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