• Surgical endoscopy · Jun 2013

    Comparative Study

    Totally laparoscopic liver resections for primary and metastatic cancer in the elderly: safety, feasibility and short-term outcomes.

    • Marcello Giuseppe Spampinato, Marianna Arvanitakis, Francesco Puleo, Lucio Mandala, Giuseppe Quarta, Donatella Traisci, Antonella Plaia, Nicola Di Bartolomeo, Giànandrea Baldazzi, and Umberto Cillo.
    • HPB and Advanced Laparoscopic Surgical Unit, Department of General and Minimally Invasive Surgery, Policlinic of Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy. marcello.spampinato@gmail.com
    • Surg Endosc. 2013 Jun 1; 27 (6): 1881-6.

    BackgroundStandard oncologic liver resections performed on elderly patients (≥70 years old) have been shown to be safe and effective. The aim of this study was to analyze operative and oncologic short-term outcomes of totally laparoscopic liver resections (TLLR) performed on elderly patients for malignancies.MethodsWe performed a retrospective statistical analysis of prospectively recorded data of TLLR performed from October 2008 to February 2012 by a single hepato-pancreato-biliary (HPB) surgeon. Patients were divided into two groups according to age (<70 vs. ≥ 70 years old) and perioperative outcomes were compared.ResultA total of 60 TLLR for malignancies were identified of which 25 patients (42 %) were aged ≥ 70 years (Group A) and 35 (58 %) were aged <70 years (Group B). There was no difference in operative time (170 vs. 180 min, p = 0.267), median blood loss (200 vs. 250 ml, p = 0.183), number and time of Pringle maneuver (p = 0.563 and p = 0.180), blood transfusion rate (4 vs. 17 %, p = 0.222), conversion rate (4 vs. 9 %, p = 0.443), morbidity rate (12 vs. 20 %, p = 0.797), and perioperative mortality rate (0 vs. 3 %, p = 0.688). An R0 resection was achieved in 92 (Group A) versus 83 % (Group B) (p = 0.265). At a median follow-up of 18 months, 12 % of patients in Group A experienced a disease recurrence with a related mortality rate similar to that of Group B (8 vs. 12 %, p = 0.375).ConclusionThis retrospective comparative study shows that TLLR performed on elderly for liver neoplasm are feasible and safe and lead to short-term outcomes similar to those of younger patients.

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