TY - JOUR
T1 - Limited upper midline incision for major hepatectomy in adults
T2 - Safety and feasibility
AU - Mahamid, Ahmad
AU - Fenig, Yaniv
AU - Amodeo, Salvatore
AU - Facciuto, Lucas
AU - Vonahrens, Dagny
AU - Sulimani, Omri
AU - Schiano, Thomas
AU - Facciuto, Marcelo
N1 - Publisher Copyright:
© 2021 Bilimsel Tip Yayinevi. All rights reserved.
PY - 2021
Y1 - 2021
N2 - Objective: Optimal incision for major hepatectomy remains controversial. In this study, we described our experience with a limited upper midline incision (UMI) for major hepatectomy. The objective was to analyze the feasibility and safety of UMI in major hepatectomy. Material and Methods: Fifty-seven consecutive patients who underwent major hepatectomies performed via an UMI were compared to a control group of 36 patients who underwent major hepatectomies with a conventional incision (CI). Results: In 85% of the patients, the indication was malignancy, with a median tumor size of 6 cm. Fifty-three percent of the patients had underlying chronic liver disease, and liver fibrosis was found in 61% of the patients. Ninteen percent of the patients had previous upper abdominal surgery. Twentysix patients underwent left hepatectomy, 20 patients had right hepatectomy and 11 patients trisegmentectomy. Additional combined surgical procedures were performed in 42% of the patients. Median operative time was 323 minutes, estimated blood loss was 500 ml, and median post-operative hospital stay was seven days. Surgical complications occurred in 22 patients (39%). 5-year overall survival was 67%. When compared with the control group with CI, patients with UMI had no statistical difference on operative time, estimated blood loss, length of hospital stay, complication rate, and overall survival. Conclusion: Major hepatectomies can be safely performed through UMI. This approach should be considered as a reasonable option in addition to conventional and laparoscopic approaches for major hepatectomies.
AB - Objective: Optimal incision for major hepatectomy remains controversial. In this study, we described our experience with a limited upper midline incision (UMI) for major hepatectomy. The objective was to analyze the feasibility and safety of UMI in major hepatectomy. Material and Methods: Fifty-seven consecutive patients who underwent major hepatectomies performed via an UMI were compared to a control group of 36 patients who underwent major hepatectomies with a conventional incision (CI). Results: In 85% of the patients, the indication was malignancy, with a median tumor size of 6 cm. Fifty-three percent of the patients had underlying chronic liver disease, and liver fibrosis was found in 61% of the patients. Ninteen percent of the patients had previous upper abdominal surgery. Twentysix patients underwent left hepatectomy, 20 patients had right hepatectomy and 11 patients trisegmentectomy. Additional combined surgical procedures were performed in 42% of the patients. Median operative time was 323 minutes, estimated blood loss was 500 ml, and median post-operative hospital stay was seven days. Surgical complications occurred in 22 patients (39%). 5-year overall survival was 67%. When compared with the control group with CI, patients with UMI had no statistical difference on operative time, estimated blood loss, length of hospital stay, complication rate, and overall survival. Conclusion: Major hepatectomies can be safely performed through UMI. This approach should be considered as a reasonable option in addition to conventional and laparoscopic approaches for major hepatectomies.
KW - Left hepatectomy
KW - Major hepatectomy
KW - Right hepatectomy
KW - Trisegmentectomy
KW - Upper midline incision
UR - http://www.scopus.com/inward/record.url?scp=85124188973&partnerID=8YFLogxK
U2 - 10.47717/turkjsurg.2021.5389
DO - 10.47717/turkjsurg.2021.5389
M3 - Article
AN - SCOPUS:85124188973
SN - 1300-0705
VL - 37
SP - 379
EP - 386
JO - Turkish Journal of Surgery
JF - Turkish Journal of Surgery
IS - 4
ER -