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Can minimally invasive liver resection change the treatment strategy for HCC patients?
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Zenichi Morise1,
Yukio Asano2,
Akihiko Horiguchi2 |
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1Department of Surgery, Fujita Health University Okazaki Medical Center, 2Department of Gastroenterological Surgery, Fujita Health University School of Medicine, Bantane Hospital |
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| During the development of Minimally invasive liver resection [MILR], its specific advantages were discussed. We reported the novel concept of caudal approach to MILR in 2013 [1] defined as a main conceptual change in the 2nd International Consensus Conference. This approach can cause the benefits for the HCC with chronic liver diseases [CLD] patients who sometimes develop postoperative liver failure and often need repeated treatments to multifocal and metachronous HCCs [2,3]. This approach to the liver protected inside subphrenic rib cage can make minimum manipulation [damage] on the residual liver and surrounding structure [collateral vessels in CLD patients etc] possible and leads to less morbidity plus deterioration of liver function. Similarly, repeat liver resection can be performed with minimum adhesiolysis, causing the benefits of less blood loss and morbidity [4]. Anatomical resection is recommended for HCC. Precise small anatomical MILR using simulation and navigation [ICG staining etc.] could work with advantages. Robotic assistance may make the complicated small resection for severe cirrhotic patients possible. MILR may change the treatment strategy for HCC, as its nature of new strong local therapy. We present the data with videos. References 1 World J Gastrointest Surg 2013;5:173-7, 2 J Hepatobiliary Pancreat Sci. 2015;22:342-352, 3 J Hepatol. 2020;72:75-84, 4 Br J Surg. 2020;107:889-895. |
Index Term 1: Minimally-invasive liver resection
Index Term 2: HCC
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