Minimally-invasive liver resection in pediatric patients: initial experience and outcomes

作者：Veenstra Michelle A^*; Koffron Alan J

来源：Hepato Pancreato Biliary, 2016, 18(6): 518-522.

DOI：10.1016/j.hpb.2015.11.004

Background: Minimally Invasive Liver Resection (MILR) is an evolving procedure in the adult population for benign and malignant lesions, offering less morbidity while maintaining acceptable outcomes. However, there lacks a published MILR experience in the pediatric population besides case reports. This report describes a pediatric MILR experience in terms of pathology, clinical specifics, and patient outcomes.
Methods: This is a retrospective review of 36 pediatric patients undergoing MILR for benign and malignant conditions. MILR was performed by pure laparoscopy, hand-assisted laparoscopy, and a hybrid laparoscopic assisted method. Data points reviewed include patient demographics, pathology, operative technique, complications, and recurrence.
Results: Patients with benign (15) and malignant (21) conditions underwent segmentectomy, sectionectomy, or hemihepatectomy by MILR. Thirty-one were completed with pure laparoscopy and 20 underwent hemihepatectomy. Operative time and blood loss correlated with magnitude of resection with five patients requiring a blood transfusion. Complications were minor and included a seroma, port infection, port dehiscence, line infection, and hypertrophic scar. At median follow-up of 12 months (range 6-36 months), there were no mortalities, re-operations, or recurrences.
Discussion: MILR can be performed in pediatric patients for benign and malignant conditions with good technical and oncologic outcomes and low morbidity.

• 出版日期2016-6