Feasibility of laparoscopic hepatectomy of malignant liver tumors under day surgery management model: based on concept of enhanced recovery after surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Jiakao ^1,2 , HAN Chuangye ^1,2 , PENG Kai ^1,2 , WU Longyan ³ , QIAN Jing ⁴ ,  PENG Tao ^1,2

1. Department of Hepatobiliary Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
2. Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, Nanning 530021, P. R. China;
3. Day Surgery Center, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;
4. Medical Insurance Management Office, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, P. R. China;

Corresponding?author：

PENG Tao, Email: pengtaogmu@163.com

Keywords：

day surgery; enhanced recovery after surgery; laparoscopic hepatectomy; malignant liver tumor

DOI：

10.7507/1007-9424.202506040

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the feasibility of laparoscopic hepatectomy of malignant liver tumors under the day surgery management model based on the concept of enhanced recovery after surgery (ERAS). Methods Three patients who underwent laparoscopic resection of malignant liver tumors under day surgery model in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Guangxi Medical University from June to November 2022 were retrospectively collected. The clinical application effects of this model were comprehensively evaluated. Results All 3 patients (cases 1–3) successfully completed complete laparoscopic partial liver resection, with operation time of 155, 183, and 201 min, respectively, as well as intraoperative blood loss of 20, 100, and 50 mL, respectively. Postoperative pathology confirmed that cases 1 and 2 were hepatocellular carcinoma, and case 3 was rectal adenocarcinoma with liver metastasis, and the resection margins all met the R0 standard. All patients resumed oral feeding at 6 h after surgery and were able to get out of bed at 8 h after surgery. All 3 patients were discharged within 24 h after surgery. The hospitalization cost of the three patients was (22 602.0±3 400.0) yuan. All patients were followed up for more than 24 months and maintained a tumor-free survival state, without tumor recurrence and metastasis. Conclusion The results of this limited cases suggest that laparoscopic liver resection under day surgery model is initially feasible and safe for strictly selected patients with liver malignancies combined with a standardized ERAS management pathway.

Citation： ZHANG Jiakao, HAN Chuangye, PENG Kai, WU Longyan, QIAN Jing, PENG Tao. Feasibility of laparoscopic hepatectomy of malignant liver tumors under day surgery management model: based on concept of enhanced recovery after surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2025, 32(8): 948-953. doi: 10.7507/1007-9424.202506040 Copy

1.	Nicoll JH. The surgery of infancy. Br Med J, 1909, 2(753): 4-5.
2.	韓超, 祝學梅, 王瑩, 等. 日間醫療的規范化發展思考. 實用醫學雜志, 2024, 40(8): 1038-1041.
3.	蔣麗莎, 馬洪升. 中國日間手術高質量發展之我見. 華西醫學, 2023, 38(2): 161-164.
4.	孫輝, 王凱, 朱宏, 等. 2016-2022年我國日間手術術式變化及對日間手術規范化發展的思考. 中國醫院, 2022, 26(8): 10-13.
5.	Reich H, McGlynn F, Wilkie W. Laparoscopic excision of benign liver lesions. Obstet Gynecol, 1991, 78(5 Pt 2): 956-958.
6.	Ban D, Tanabe M, Kumamaru H, et al. Safe dissemination of laparoscopic liver resection in 27 146 cases between 2011 and 2017 from the National Clinical Database of Japan. Ann Surg, 2021, 274(6): 1043-1050.
7.	Ibuki S, Hibi T, Tanabe M, et al. Short-term outcomes of “difficult” laparoscopic liver resection at specialized centers: report from INSTALL (International Survey on Technical Aspects of Laparoscopic Liver Resection)-2 on 4 478 patients. Ann Surg, 2022, 275(5): 940-946.
8.	Zhu P, Liao W, Zhang WG, et al. A prospective study using propensity score matching to compare long-term survival outcomes after robotic-assisted, laparoscopic, or open liver resection for patients with BCLC stage 0–A hepatocellular carcinoma. Ann Surg, 2023, 277(1): e103-e111. doi: 10.1097/SLA.0000000000005380.
9.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
10.	Tranchart H, Fuks D, Lainas P, et al. Laparoscopic liver surgery: towards a day-case management. Surg Endosc, 2017, 31(12): 5295-5302.
11.	中國心胸血管麻醉學會日間手術麻醉分會, “基于術后加速康復的日歸手術全程管理專家共識”工作組. 基于術后加速康復的日歸手術全程管理專家共識. 中華麻醉學雜志, 2023, 43(4): 385-399.
12.	Rebibo L, Leourier P, Badaoui R, et al. Minor laparoscopic liver resection as day-case surgery (without overnight hospitalisation): a pilot study. Surg Endosc, 2019, 33(1): 261-271.
13.	Yeung KTD, Vellaisamy R, Hussain A, et al. Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre. Surg Endosc, 2024, 38(8): 4329-4335.
14.	潘立超, 王兆海, 劉榮. 日間肝切除術2例報道. 中華腔鏡外科雜志(電子版), 2024, 17(4): 253-256.
15.	加速康復外科專家委員會, 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識暨路徑管理指南(2018): 肝膽手術部分. 中華麻醉學雜志, 2018, 38(1): 13-18.
16.	李志超, 王煜, 王小成, 等. 基于快速康復外科理念的疼痛管理模式在日間腹腔鏡膽囊切除術的應用. 華西醫學, 2015, 30(5): 804-807.
17.	林德新, 李旋, 張勇, 等. 加速康復外科程序在肝膽管結石肝切除術中的應用. 中國普通外科雜志, 2018, 27(2): 169-174.
18.	方寧波, 陳偉力. 腹腔鏡膽囊切除術日間手術圍術期指標觀察及患者延遲出院原因分析. 江西醫藥, 2022, 57(10): 1524-1527.
19.	胡若男, 胡超華. 快速康復理念下多模式鎮痛在腹腔鏡膽囊切除術中的應用研究. 實用肝臟病雜志, 2018, 21(5): 777-780.
20.	陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 2019, 34(2): 155-158.
21.	湯佳禎. 基于快速康復外科理念的多學科協作模式在腹腔鏡下肝切除患者圍手術期護理中的應用. 文科技期刊數據庫(引文版)醫藥衛生, 2022, 11(11): 16-19.
22.	葉志霞. 加速康復外科理念在肝切除圍手術期護理中的應用思考. 上海護理, 2022, 22(10): 1-5.
23.	俞德梁, 劉小南. 日間手術發展展望. 醫學與哲學, 2022, 43(22): 61-64.

1. Nicoll JH. The surgery of infancy. Br Med J, 1909, 2(753): 4-5.
2. 韓超, 祝學梅, 王瑩, 等. 日間醫療的規范化發展思考. 實用醫學雜志, 2024, 40(8): 1038-1041.
3. 蔣麗莎, 馬洪升. 中國日間手術高質量發展之我見. 華西醫學, 2023, 38(2): 161-164.
4. 孫輝, 王凱, 朱宏, 等. 2016-2022年我國日間手術術式變化及對日間手術規范化發展的思考. 中國醫院, 2022, 26(8): 10-13.
5. Reich H, McGlynn F, Wilkie W. Laparoscopic excision of benign liver lesions. Obstet Gynecol, 1991, 78(5 Pt 2): 956-958.
6. Ban D, Tanabe M, Kumamaru H, et al. Safe dissemination of laparoscopic liver resection in 27 146 cases between 2011 and 2017 from the National Clinical Database of Japan. Ann Surg, 2021, 274(6): 1043-1050.
7. Ibuki S, Hibi T, Tanabe M, et al. Short-term outcomes of “difficult” laparoscopic liver resection at specialized centers: report from INSTALL (International Survey on Technical Aspects of Laparoscopic Liver Resection)-2 on 4 478 patients. Ann Surg, 2022, 275(5): 940-946.
8. Zhu P, Liao W, Zhang WG, et al. A prospective study using propensity score matching to compare long-term survival outcomes after robotic-assisted, laparoscopic, or open liver resection for patients with BCLC stage 0–A hepatocellular carcinoma. Ann Surg, 2023, 277(1): e103-e111. doi: 10.1097/SLA.0000000000005380.
9. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
10. Tranchart H, Fuks D, Lainas P, et al. Laparoscopic liver surgery: towards a day-case management. Surg Endosc, 2017, 31(12): 5295-5302.
11. 中國心胸血管麻醉學會日間手術麻醉分會, “基于術后加速康復的日歸手術全程管理專家共識”工作組. 基于術后加速康復的日歸手術全程管理專家共識. 中華麻醉學雜志, 2023, 43(4): 385-399.
12. Rebibo L, Leourier P, Badaoui R, et al. Minor laparoscopic liver resection as day-case surgery (without overnight hospitalisation): a pilot study. Surg Endosc, 2019, 33(1): 261-271.
13. Yeung KTD, Vellaisamy R, Hussain A, et al. Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre. Surg Endosc, 2024, 38(8): 4329-4335.
14. 潘立超, 王兆海, 劉榮. 日間肝切除術2例報道. 中華腔鏡外科雜志(電子版), 2024, 17(4): 253-256.
15. 加速康復外科專家委員會, 中華醫學會外科學分會, 中華醫學會麻醉學分會. 加速康復外科中國專家共識暨路徑管理指南(2018): 肝膽手術部分. 中華麻醉學雜志, 2018, 38(1): 13-18.
16. 李志超, 王煜, 王小成, 等. 基于快速康復外科理念的疼痛管理模式在日間腹腔鏡膽囊切除術的應用. 華西醫學, 2015, 30(5): 804-807.
17. 林德新, 李旋, 張勇, 等. 加速康復外科程序在肝膽管結石肝切除術中的應用. 中國普通外科雜志, 2018, 27(2): 169-174.
18. 方寧波, 陳偉力. 腹腔鏡膽囊切除術日間手術圍術期指標觀察及患者延遲出院原因分析. 江西醫藥, 2022, 57(10): 1524-1527.
19. 胡若男, 胡超華. 快速康復理念下多模式鎮痛在腹腔鏡膽囊切除術中的應用研究. 實用肝臟病雜志, 2018, 21(5): 777-780.
20. 陳相軍, 宋應寒, 陳敏, 等. 四川大學華西醫院日間手術質量和安全管理規范. 華西醫學, 2019, 34(2): 155-158.
21. 湯佳禎. 基于快速康復外科理念的多學科協作模式在腹腔鏡下肝切除患者圍手術期護理中的應用. 文科技期刊數據庫(引文版)醫藥衛生, 2022, 11(11): 16-19.
22. 葉志霞. 加速康復外科理念在肝切除圍手術期護理中的應用思考. 上海護理, 2022, 22(10): 1-5.
23. 俞德梁, 劉小南. 日間手術發展展望. 醫學與哲學, 2022, 43(22): 61-64.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Feasibility of laparoscopic hepatectomy of malignant liver tumors under day surgery management model: based on concept of enhanced recovery after surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content