Ban et al reported a score for predicting the difficulty of performing laparoscopic resection of hepatic metastases from a colorectal carcinoma. The authors are from Tokyo Medical and Dental University, Toho University, Iwate Medical University and Keio University in Japan.
Patient selection: laparoscopic resection of hepatic metastases from a colorectal cancer
Parameter:
(1) tumor location (Couinaud segment)
(2) extent of liver resection
(3) tumor size
(4) proximity to major vessel
(5) liver function (Child-Pugh status)
Parameter
Finding
Points
tumor location
S2
2
S3
1
S4
3
S5
3
S6
2
S7
5
S8
5
extent of resection
partial resection
0
left lateral sectionectomy
2
segmentectomy
3
sectionectomy and more
4
tumor size
< 3 cm
0
>= 3 cm
1
proximity to major vessel
no
0
yes
1
liver function
Child Pugh A
0
Child Pugh B
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
Score
Difficulty
0 to 3
low
4 to 6
intermediate
>= 7
high
Later a score >= 10 was considered requiring an expert surgeon.
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