Topic: Advances in Minimally Invasive Cirrhotic Surgery

Hepatocellular carcinoma (HCC) is the sixth most common type of cancer worldwide and the third leading cause of cancer-related death. It is the most common primary liver cancer and its incidence increases when associated with the development of cirrhosis. Liver resection is a curative therapy, when liver transplantation due to the patient age and alcohol abuse, associated diseases, and shortage of donors, is not feasible. During the past decades, progress in preoperative patient assessment, refinement of the indications for resection, improved surgical technique, and the development of new surgical devices have greatly enhanced the safety of open hepatectomy in normal and even in cirrhotic liver. In fact, the role of the mininvasive approach in liver surgery continues to increase, and many types of liver resections, even in cirrhotic liver, including major hepatectomies, are now performed laparoscopically in specialized centers. It is now clear that laparoscopic liver resection for HCC on cirrhotic liver has better short results when compared to an open approach. In fact, despite its technical challenges, reduced operative blood loss, fewer early postoperative complications, such as postoperative ascites, lower analgesic drug requirements, and shorter hospital stay are the clear advantages of the laparoscopic approach. Therefore, laparoscopic resection of HCC in cirrhotic liver is not only feasible and safe in selected patients with excellent short-term results, but achieves not inferior long-term survival end recurrence rates compared with open surgery when stratified for tumor characteristics known to be related to survival outcome.
In this Special Issue of Hepatoma Research focusing on “Advances in Minimally Invasive Cirrhotic Surgery”, the challenges of this rapidly developing field are addressed. Each of the contributors has referred to specific aspects of their experienced area, discussing its limits but also its advantages. They have also discussed their technique and results.

7 Jul 2016