Laparoscopic repeat hepatectomy for treating recurrent liver cancer

Area of Science:

• Hepatobiliary surgery
• Minimally invasive surgery
• Surgical oncology

Background:

• Laparoscopic repeat hepatectomy (LRH) is a complex procedure with limited acceptance for recurrent liver cancer.
• Data on LRH for recurrent hepatocellular carcinoma (rHCC) and liver metastases, particularly colorectal liver metastases (CRLM), requires evaluation.

Purpose of the Study:

• To systematically review and evaluate the safety and feasibility of LRH for rHCC and CRLM.
• To assess the current literature on LRH for recurrent liver tumors.

Main Methods:

• A systematic literature search was conducted on PubMed for studies published in English from January 2005 to June 2019.
• Included studies focused on LRH for rHCC and liver metastases.

Main Results:

• Fifteen studies involving 444 patients reported on the efficacy and safety of LRH for rHCC or CRLM.
• Nine studies comparing LRH with open repeat hepatectomy (ORH) showed LRH had reduced blood loss, shorter operative time, shorter hospital stay, and lower morbidity.
• LRH demonstrated superiority over ORH in perioperative outcomes.

Conclusions:

• Laparoscopic repeat hepatectomy (LRH) is a safe option for patients with recurrent liver cancer (rHCC or CRLM).
• LRH is feasible even in patients with cirrhosis, prior open hepatectomy, multiple lesions, or tumors in difficult locations.
• The findings support the wider adoption of LRH for selected recurrent liver cancer cases.