Multimodality laparoscopic liver resection for XXXX --from conventional total laparoscopic approach to robot-assisted laparoscopic approach.

@entity1 @entity157 @entity99 @entity190
INTRODUCTION: Laparoscopic liver resection can either be total laparoscopic or hand-assisted laparoscopic approach. The recent introduction of robotic surgical systems has revolutionized the field of minimally invasive surgery. It was developed to overcome the disadvantages of conventional laparoscopic surgery. The role of robotic system in laparoscopic surgery was not well evaluated yet. The aim of this cohort study was to evaluate the outcome of multimodality approach of laparoscopic liver resection for @entity99 METHODS: From January 1998 to August 2010, all @entity1 with @entity99 underwent laparoscopic liver resection were included. A prospectively collected data was analyzed retrospectively. RESULTS: During the study period, a total of 56 @entity1 with @entity99 ( @entity157 , @entity157 , n = 42; colorectal liver metastases, CLM, n = 14) underwent laparoscopic liver resection in our surgical unit. The majority of cases were performed by hand-assisted laparoscopic approach, n = 31 (55.3%) and the remainder were with total laparoscopic approach, n = 10 (17.9%) and robot-assisted laparoscopic approach, n = 15 (26.8%). The median operation time was 150 min (range, 75-307 min). The median @entity190 during surgery was 175 ml (range, 5-2000 ml). Two @entity1 (3.6%) needed open conversion and one @entity1 (1.8%) needed to be converted to hand-assisted laparoscopic approach. The morbidity rate was 14.3%. There was no procedure-related death. 89.3% of @entity1 had R0 resection and 10.7% of @entity1 had R1 resection. The median hospital stay was 6.5 days (range, 2-13 days). The 1-year, 3-year, and 5-year disease-free survival rates for @entity157 were 85%, 47%, and 38%, respectively. The 1-year, 3-year, and 5-year overall survival rates for @entity157 were 96%, 67%, and 52%, respectively. The 1-year, and 3-year disease-free survival rates for CLM were 92% and 72%. The 1-year, and 3-year overall survival rates for CLM were 100% and 88%, respectively. CONCLUSIONS: Multimodality approach of laparoscopic liver resection of @entity99 was feasible, and safe in selected @entity1 . It was associated with a low complications rate. The mid-term and long-term survival outcome was favorable also.
