A Literature Review to Assess Blood Loss in Minimally Invasive Liver Surgery Versus in Open Liver Resection.

Aim and objectives The aim of the study was to assess the amount of blood loss in minimally invasive hepatectomy and open liver resection for both benign and neoplastic conditions. Introduction Minimally invasive surgery has progressively developed to a stage where once-novel and highly specialized surgical techniques are now common practice. Colorectal surgery is the key example that has shown minimally invasive surgery as highly beneficial. Successes in the colorectal laparoscopic approach have now been integrated into the speciality of hepatopancreaticobiiary (HPB) surgery. In this review, we will compare the amount of blood loss in minimally invasive liver resection with the more traditional approach of open liver resection. Methods A literature review was conducted which included the length of patient mobilization as a postoperative complication following laparoscopic and open liver resections. Medline, PubMed, and Cochrane were accessed to review previously published studies. Twelve studies were selected, and all of them were in English, ranged from the year 2000 to 2020. Results Eleven out of the 12 included studies indicated that minimally invasive liver resection is associated with reduced blood loss. Conclusion In comparing both minimally invasive liver resection and classic open surgery, minimally invasive liver resection was shown to have reduced blood loss; this was seen in both malignant and benign tumours. Therefore, laparoscopic liver resection could be favoured over the classical open approach to avoid excessive blood loss intra-operatively.

Skull base chondroblastoma presenting as a deep lobe parotid tumour.

Chondroblastomas are rare, benign cartilage-producing primary bone tumours that account for 1% of all primary bone tumours. They are usually seen in young adult males and affect long tubulous bones such as the femur or humerus. Occurrences in non-tubular flat bones such as the craniofacial skeleton do occur but are seen in older adults. With only around 100 cases reported in the English literature, 'Temporal Bone Chondroblastomas' can present a diagnostic challenge for both surgeon and histopathologist. Clinical presentation can be subtle and patients may have longstanding symptoms due to compression of surrounding structures. Imaging in the form of contrast CT and/or MRI is recommended to assess size, proximity to neurovascular structures and plan operative approach. Definitive treatment is surgical excision, with radiotherapy reserved for recurrence or unfit surgical patients. Long-term follow-up is recommended for surveillance due to high recurrence rates. We present our experience managing this rare entity.