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Comparison of outcome between extended and nonextended liver resections for neoplasms
J N Vauthey1, H U Baer, T Guastella
1Clinic of Visceral and Transplantation Surgery, Inselspital Bern-University of Bern, Switzerland.
Background:
An aggressive approach to liver resection for neoplasms was adopted during a 5-year period. The results were evaluated by comparing the outcome between extended and nonextended liver resections.
Methods:
Among 73 consecutive patients undergoing liver resections for neoplasm or suspicion of neoplasm, 33 underwent extended liver resections (26 extended right lobectomies and 7 extended left lobectomies) and 40 underwent resections of lesser extent. Mortality, morbidity, and survival between the two groups were compared.
Results:
Overall morbidity was 21% and perioperative mortality was 5.4%. Morbidity and mortality were not significantly different between extended and nonextended liver resections (24% vs 18% and 6.1% vs 5.0%, respectively). Liver resections for extrahepatic cholangiocarcinomas were found to be associated with a higher morbidity (6 of 10) and mortality (2 of 10) when compared with liver resections for noncholangiocarcinomas. Bile leaks occurred mainly in patients with cholangiocarcinomas (4 of 6) and contributed to an increased overall morbidity in this series. After a median follow-up of 31 months, there was no difference in survival between extended and nonextended liver resections.
Conclusions:
Extensive liver resections for neoplasms can be carried out without significant increase in the operative risk. Short-term survival is comparable between patients undergoing extended and nonextended liver resections.