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 ORIGINAL ARTICLE
Year : 2022  |  Volume : 18  |  Issue : 1  |  Page : 51-57

First 100 minimally invasive liver resections in a new tertiary referral centre for liver surgery


1 Department of General Surgery, Morgagni-Pierantoni Hospital, Forli, Italy
2 Department of General Surgery, Morgagni-Pierantoni Hospital, Forli; Department of Medical and Surgical Sciences, DIMEC; Alma Mater Studiorum, University of Bologna, Italy

Correspondence Address:
Leonardo Solaini
Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì; Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmas.JMAS_310_20

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Background: In the last decades, there has been an exponential diffusion of minimally invasive liver surgery (MILS) worldwide. The aim of this study was to evaluate our initial experience of 100 patients undergoing MILS resection comparing their outcomes with the standard open procedures. Materials and Methods: One hundred consecutive MILS from 2016 to 2019 were included. Clinicopathological data were reviewed to evaluate outcomes. Standard open resections were used as the control group and compared exploiting propensity score matching. Results: In total, 290 patients were included. The rate of MILS has been constantly increasing throughout years, representing the 48% in 2019. Of 100 (34.5%) MILS patients, 85 could be matched. After matching, the MILS conversion rate was 5.8% (n = 5). The post-operative complication rates were higher in the open group (45.9% vs. 31.8%, P = 0.004). Post-operative blood transfusions were less common in the MILS group (4.7% vs. 16.5%, P = 0.021). Biliary leak occurred in 2 (2.4) MILS versus 13 (15.3) open. The median comprehensive complication index was higher in the open group (8.7 [0–28.6] vs. 0 [0–10.4], P = 0.0009). The post-operative length of hospital stay was shorter after MILS (median 6 [5–8] vs 8 [7–13] days, P < 0.0001). Conclusions: The rate of MILS has been significantly increasing throughout the years. The benefits of MILS over the traditional open approach were confirmed. The main advantages include lower rates of post-operative complications, blood transfusions, bile leaks and a significantly decreased hospital stay.






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