Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2019; 7(20): 3194-3201
Published online Oct 26, 2019. doi: 10.12998/wjcc.v7.i20.3194
Feasibility of laparoscopic isolated caudate lobe resection for rare hepatic mesenchymal neoplasms
Yang Li, Kai-Ning Zeng, Dan-Yun Ruan, Jia Yao, Yang Yang, Gui-Hua Chen, Gen-Shu Wang
Yang Li, Kai-Ning Zeng, Jia Yao, Yang Yang, Gui-Hua Chen, Gen-Shu Wang, Department of Liver Surgery and Liver Transplantation, Guangzhou Clinical Research and Translation Center for Liver Disease, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Dan-Yun Ruan, Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Li Y and Wang GS take responsibility for the integrity of the data and the accuracy of the data analysis. Li Y, Zeng KN, Ruan DY, and Wang GS designed the study, drafted the manuscript, and provided administrative support and supervision; Yao J, Yang Y, and Chen GH acquired the data; Li Y, Zeng KN, and Ruan DY analyzed and interpreted the data; Wang GS corrected the manuscript for controversial content; Zeng KN performed statistical analysis; Li Y, Zeng KN, and Ruan DY contributed equally to this work.
Supported by the National Natural Science Foundation of China, No. 81600505; Medical Scientific Research Foundation of Guangdong Province, No. A2017370.
Institutional review board statement: The research was approved by the ethics committee of The Third Affiliated Hospital of Sun Yat-sen University.
Informed consent statement: All study participants provided written informed consent prior to study enrollment.
Conflict-of-interest statement: All authors have nothing to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gen-Shu Wang, MD, PhD, Doctor, Professor, Surgeon, Department of Liver Surgery and Liver transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600# Tianhe Road, Guangzhou 510630, Guangdong Province, China. wanggshu@mail.sysu.edu.cn
Telephone: +86-20-85252177 Fax: +86-20-85252276
Received: June 4, 2019
Peer-review started: June 6, 2019
First decision: July 30, 2019
Revised: August 29, 2019
Accepted: September 9, 2019
Article in press: September 9, 2019
Published online: October 26, 2019
Processing time: 144 Days and 12.1 Hours
Abstract
BACKGROUND

Mesenchymal tumors such as perivascular epithelioid cell neoplasm (PEComa) and inflammatory pseudotumor-like follicular dendritic cell sarcoma (IPT-like FDC sarcoma) are relatively uncommon in the liver and are particularly rare in the caudate lobe. The clinical manifestations and available imaging tests lack specificity for hepatic mesenchymal tumors. To the best of our knowledge, no caudate PEComa or IPT-like FDC sarcoma has been completely resected by laparoscopy. The standard laparoscopic technique, surgical approaches, and tumor margins for potentially malignant or malignant caudate mesenchymal tumors are still being explored.

AIM

To assess both the safety and feasibility of laparoscopic resection for rare caudate mesenchymal neoplasms.

METHODS

Eleven patients who underwent isolated caudate lobe resection from 2003 to 2017 were identified from a prospective database. Three consecutive patients with rare caudate mesenchymal tumors underwent laparoscopic resection. Patient demographic data, intraoperative parameters, and postoperative outcomes were assessed and compared with the open surgery group.

RESULTS

All procedures for the three resection patients with caudate mesenchymal tumors were completed using a total laparoscopic technique by two different approaches. The average operative time was 226 min, and the estimated blood loss was 133 mL. The average length of postoperative hospital stay was 6.3 ± 0.3 d for the laparoscopy group and 15.5 ± 2.3 d for the open surgery group (P < 0.05). There were no perioperative complications or patient deaths in this series.

CONCLUSION

Laparoscopic isolated caudate lobe resection for rare mesenchymal neoplasms is a feasible and curative surgical option in selected patients.

Keywords: Laparoscopic liver resection; Caudate lobe; Perivascular epithelioid cell neoplasm; Inflammatory pseudotumor-like follicular dendritic cell sarcoma

Core tip: Although laparoscopic liver resection is now considered a standard procedure in peripheral segments, there are a limited number of reports focused on laparoscopic caudate lobe resection. Perivascular epithelioid cell neoplasm and inflammatory pseudotumor-like follicular dendritic cell sarcoma are particularly rare mesenchymal neoplasms in the liver, especially in the caudate lobe. Laparoscopic resection provides better quality of care and shortens hospital stay relative to open surgery. For such rare mesenchymal neoplasms, laparoscopic isolated caudate lobe resection is a feasible and curative surgical option in selected patients.