Laennec approach for anatomical liver resection assisted by laparoscopy or robotics: a multicenter cohort study

作者：Binghua Li, Dalong Yin, Qifan Zhang, Lei Qin, Jianwei Li, Zhixian Hong, Peng Zhu, Guangyu Ding, Zhitian Shi, Changhe Zhang, Kai Zhang, Jinrong Peng, Yue Yang, Chaobo Chen, Lianxin Liu, Shuguo Zheng, Xiaoping Chen, Qiang Gao, Bixiang Zhang, Decai Yu · 发表于：International Journal of Surgery · 年份：2025 · DOI：10.1097/js9.0000000000002212 · 被引用次数：8 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes、Minimally Invasive Surgical Techniques

INTRODUCTION: Laennec's capsule serves as a critical anatomical landmark in liver resection. Despite its potential, a lack of large-scale prospective studies limits the widespread use of the Laennec approach for minimally invasive hepatectomy. This multicenter cohort study aimed to compare the outcomes of the traditional and Laennec approaches in minimally invasive anatomical hepatectomy across multiple centers in China. METHODS: A total of 445 patients from 11 centers were included, with 339 undergoing the Laennec approach and 106 receiving the traditional approach. Intraoperative parameters such as the duration of hepatic pedicle isolation, hepatic vein exposure, parenchymal transection, and liver mobilization were analyzed. Postoperative outcomes, including recurrence-free survival and R0 resection rates, were also assessed. Additionally, a series of subgroup analyses were conducted to evaluate the efficacy of the Laennec approach. RESULTS: The Laennec approach demonstrated notable intraoperative advantages, including reduced durations for hepatic pedicle isolation, liver mobilization, hepatic vein exposure, and parenchymal transection. Robotic-assisted procedures, in particular, showed superior outcomes when compared with laparoscopic platform. The Laennec approach proved highly effective across various liver diseases, particularly hepatocellular carcinoma, hemangioma, and hepatolithiasis. The Laennec gap, a distinct gap between the liver parenchyma and surrounding vascul...