Repeat liver surgery by laparoscopy for a malignant recurrence after previous open or laparoscopic resection

Aim: This paper reported the experience of one center on repeat laparoscopic liver surgery for metastasis and hepatocellular carcinoma (HCC) with a review of the literature. Methods: This retrospective study included 24 patients who underwent laparoscopic re-intervention (hepatic resection and radiofrequency ablation) for recurrent HCC in cirrhosis ( n = 17) and for recurrent malignant metastases ( n = 7) after a previous open or laparoscopic procedure. Patients were divided into two groups according to the first surgical approach. Group 1 underwent open resection and laparoscopic procedure (7 patients), and Group 2 underwent laparoscopic resection and laparoscopic procedure (17 patients). Results: Mean operative time for re-intervention was significantly longer for Group 1 (220.14 ± 80.06 min) than for Group 2 (150 ± 56.18 min; P = 0.001), whereas the mean blood loss and mean hospital stay were comparable in both groups. According to Dindo-Clavien classification, overall morbidity ranged between Grade I and IIIa and was similar in both groups. Conclusion: This study suggests that repeat laparoscopic surgery for recurrent hepatic malignant diseases in selected patients is a feasible and safe procedure with good short-term outcomes, but further prospective studies are needed to support these results.