Combined liver-visceral resection for neoplastic lesions correlates with increased postoperative complications

ABSTRACT

Background: Combined liver-visceral resections (CLVRs) may impose increased risk of postoperative complications. The clinical outcome of CLVRs versus sole liver resection (SLR) has not been adequately reported from upper Egypt cancer surgery programs.Methods: Medical records of adult non-cirrhotic patients who electively underwent liver resection from February 2015 to April 2018 at Sohag University Hospital, Egypt, were retrospectively reviewed. Indications for liver resection comprised definitively malignant tumors and those with equivocal radiologic features. The severity of surgical complications, including mortality, was compared among patients who underwent CLVRs versus SLR control group with matching age, gender, number of resected liver segments, method of hepatic inflow occlusion and parenchyma transection techniques.Results: Twenty-six patients were enrolled, including 13 with CLVRs group and their 13 SLR control group. Histopathologic examination of resected specimens confirmed malignancy in 17 patients (10 in CLVR group and 7 in SLR group). Major liver resection (≥3 segments) was carried out in 14 (54%) patients, 7 per each group. The complication score was significantly higher in CLVRs (p<0.05). Similarly, the length of hospital and intensive care unit stays was significantly prolonged in CLVRs group (p<0.05). Overall, 2 patients died (8%), exclusively in the CLVRs. Elderly patients (>65 years) who underwent CLVRs exhibited increased complications compared with their matching controls.Conclusions: CLVR predisposes to increased morbidity rates and mortality. It should be carried out in carefully selected patients to avoid worse clinical outcome.