有限解剖切除术（LAR），例如使用完全腹腔镜方法进行的节段切除术，在肝脏恶性肿瘤中越来越受欢迎。然而，腹腔镜 LAR（Lap-LAR）的肿瘤学疗效需要进一步研究。该队列研究评估了 Lap-LAR 对肝细胞癌 (HCC) 和结直肠肝转移 (CRLM) 的肿瘤学结果。在日本转诊中心，112 名患者使用 Glissonean 方法和吲哚菁绿 (ICG) 荧光导航接受了 Lap-LAR。评估了无复发生存期 (RFS)、总生存期 (OS)、介入失败时间 (TIF) 和手术失败时间 (TSF)。 112 名患者中（中位年龄 74 岁 [范围 66-80 岁） ]；80 名男性 [71.4 %]），Lap-LAR 显示出有希望的结果。中位手术时间为 348 分钟（范围：280-460 分钟），中位失血量为 190 mL（范围：95.5-452.0 mL）。估计肝脏体积与实际肝脏体积之间的中位误差为 2% (1.2-4.8%)。 11.6% 的患者出现了高于 Clavien-Dindo 3a 的并发症。 HCC 的 5 年 RFS、OS 和 TIF 率分别为 45.1 % ± 7.9 %、73.1 % ± 6.7 % 和 74.2 % ± 6 .6 %。 CRLM 的 5 年 RFS、OS 和 TSF 率分别为 36.8% ± 8.7%、60.1% ± 13.3% 和 63.6% ± 10.4%。Lap-LAR 对 HCC 和 CRLM 显示出良好的肿瘤学结果。其精确的技术使其成为肝脏恶性肿瘤有前途的治疗选择。有必要与传统方法进行进一步比较。© 2023。外科肿瘤学会。

Limited anatomic resections (LARs), such as segmentectomies, performed using a fully laparoscopic approach, have gained popularity for liver malignancies. However, the oncologic efficacy of laparoscopic LARs (Lap-LARs) needs further investigation. This cohort study evaluated the oncologic outcomes of Lap-LAR for hepatocellular carcinoma (HCC) and colorectal liver metastasis (CRLM).At a Japanese referral center, 112 patients underwent Lap-LAR using the Glissonean approach and indocyanine green (ICG) fluorescence navigation. Recurrence-free survival (RFS), overall survival (OS), time to interventional failure (TIF), and time to surgical failure (TSF) were assessed.Among the 112 patients (median age, 74 years [range, 66-80 years]; 80 men [71.4 %]), Lap-LAR showed promising results. The median operative time was 348 min (range, 280-460 min), and the median blood loss was 190 mL (range, 95.5-452.0 mL). The median error between the estimated and actual liver volumes was 2 % (1.2-4.8 %). Complications greater than Clavien-Dindo 3a were observed in 11.6 % of the patients. The 5-year RFS, OS, and TIF rates for HCC were 45.1 % ± 7.9 %, 73.1 % ± 6.7 %, and 74.2 % ± 6 .6 %, respectively. The 5-year RFS, OS, and TSF rates for CRLM were 36.8 % ± 8.7 %, 60.1 % ± 13.3 %, and 63.6 % ± 10.4 %, respectively.Lap-LAR showed favorable oncologic outcomes for HCC and CRLM. Its precise technique makes it a promising therapeutic option for liver malignancies. Further comparisons with conventional approaches are warranted.© 2023. Society of Surgical Oncology.