Surgical Management of Hepatic Benign Disease: Have the Number of Liver Resections Increased in the Era of Minimally Inv
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ORIGINAL ARTICLE
Surgical Management of Hepatic Benign Disease: Have the Number of Liver Resections Increased in the Era of Minimally Invasive Approach? Analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry Francesco Ardito 1 & Luca Aldrighetti 2 & Alfredo Guglielmi 3 & Elio Jovine 4 & Umberto Cillo 5 & Alessandro Ferrero 6 & Luciano De Carlis 7 & Giulio Belli 8 & Raffaele Dalla Valle 9 & Abdallah Slim 10 & Vincenzo Mazzaferro 11 & Giuseppe Navarra 12 & Giuseppe M. Ettorre 13 & Fulvio Calise 14 & Antonio D. Pinna 15 & Felice Giuliante 1 & Italian Group of Minimally Invasive Liver Surgery (I Go MILS) Received: 3 February 2019 / Accepted: 1 May 2019 # 2019 The Society for Surgery of the Alimentary Tract
Abstract Background Increased expertise with minimally invasive liver surgery (MILS) could cause an unjustified extension of indications to resect liver benign disease (BD). The aim of this study was to evaluate the operative risk of MILS for BD and if implementation and diffusion of MILS have widened indications for BD resection. Methods A prospective study including centers with > 6 MILS for BD, enrolled in the I Go MILS registry from January 2015 to October 2016. Cysts fenestrations were excluded. Results Eight hundred eighteen MILS were performed in 15 centers. One hundred seventy-three of these (21.1%) were for BD: conversion rate was 6.9%, postoperative mortality and morbidity rates were 0 and 13.9%. During the same period, 3713 liver resections (open + MILS) were performed and 407 (11.0%) were for BD. A time-trend analysis showed that the total number of MILS and the number of MILS for malignant disease significantly increased, but this increasing trend was not documented for the number of MILS for BD, which remained stable during the study period of time. This trend was confirmed for the overall rate of resected BD (open + MILS) that remained stable. Discussion BD represents a valid indication for MILS. For BD, 21.1% of MILS was performed, rate significantly lower than that previously reported in Italy. Although an evident growth of the use of MILS was observed during the time period analysis in Italy,
* Francesco Ardito [email protected] 1
Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, L.go A. Gemelli, 8, 00168 Rome, Italy
2
Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy
3
General and Hepatobiliary Surgery, University of Verona, Verona, Italy
4
Department of Surgery, Maggiore Hospital, Bologna, Italy
5
Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
6
Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy
7
Department of General Surgery and Transplantation, Niguarda Ca’ Granda Hospital, Milan, Italy
8
Department of General and HPB Surgery, Loreto Nuovo Hospital, Naples, Italy
9
Department of Surgery, University of Parma, Parma, Italy
10
General Surgery Unit, Vimercate Hospital
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