Laparoscopic isolated caudate lobe resection

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Isolated caudate lobectomy is a complex surgical procedure, historically performed infrequently and often combined with resection of other liver segments.
• The caudate lobe's anatomical location presents unique surgical challenges, making its isolated resection demanding even for experienced surgeons.

Purpose of the Study:

• To evaluate the feasibility, safety, and outcomes of laparoscopic isolated caudate lobectomy.
• To compare the results of laparoscopic isolated caudate lobectomy with those of the traditional open surgical technique.

Main Methods:

• A retrospective analysis of 21 patients who underwent isolated caudate lobectomy (anatomical or non-anatomical) between January 2005 and December 2018.
• Patients were categorized into two groups: laparoscopic surgery (12 patients) and open surgery (9 patients).
• Comparison of intra-operative and postoperative outcomes, including operation time, estimated blood loss, hospital stay, complication rates, and survival rates, with a median follow-up of 43 months.

Main Results:

• Operation time, estimated blood loss, and hospital stay were comparable between the laparoscopic and open groups (p > 0.05).
• The overall postoperative complication rates were similar between the two surgical approaches (p = 0.375).
• Five-year disease-free survival (42.9% vs. 60.0%) and overall survival rates (76.2% vs. 64.8%) did not significantly differ between laparoscopic and open caudate lobectomy (p > 0.05).

Conclusions:

• Laparoscopic isolated caudate lobectomy is a feasible and safe procedure for selected patients.
• Surgical expertise and technological advancements have made minimally invasive approaches to caudate lobe resection viable.
• The outcomes of laparoscopic isolated caudate lobectomy are comparable to those of open surgery, offering a potentially less invasive alternative.