Short- and long-term outcomes of laparoscopic versus open repeat liver resection for hepatocellular carcinoma: A multicenter study.

Autor: Nomi T; Department of Hepato-Biliary-Pancreatic Surgery, Uji Tokusyukai Medical Center, Kyoto, Japan.; Department of Surgery, Nara Medical University, Kashihara, Japan., Kaibori M; Department of Surgery, Hirakata Hospital, Kansai Medical University, Osaka, Japan., Tanaka S; Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan., Hirokawa F; Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan., Hokuto D; Department of Surgery, Nara Medical University, Kashihara, Japan., Noda T; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan., Ueno M; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Nakai T; Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan., Ikoma H; Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan., Iida H; Division of Gastrointestinal, Breast, and General Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan., Matsui K; Department of Surgery, Hirakata Hospital, Kansai Medical University, Osaka, Japan., Komeda K; Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan., Hayami S; Second Department of Surgery, Wakayama Medical University, Wakayama, Japan., Eguchi H; Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan., Matsumoto M; Department of Surgery, Faculty of Medicine, Kindai University, Osaka, Japan., Morimura R; Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan., Maehira H; Division of Gastrointestinal, Breast, and General Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Japan., Yoshikawa T; Department of Surgery, Nara Medical University, Kashihara, Japan., Kubo S; Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Jazyk: angličtina
Zdroj: Journal of hepato-biliary-pancreatic sciences [J Hepatobiliary Pancreat Sci] 2023 Mar; Vol. 30 (3), pp. 283-292. Date of Electronic Publication: 2022 Aug 25.
DOI: 10.1002/jhbp.1222
Abstrakt: Objective: This multicenter study aimed to compare the short- and long-term outcomes of laparoscopic (LRLR) versus open repeat liver resection (ORLR) for recurrent hepatocellular carcinoma (HCC) using propensity score matching (PSM). Despite the expanding indications for laparoscopic liver resection, limited data regarding the outcomes of LRLR have previously been reported.
Methods: This study included patients who underwent repeat liver resection for recurrent HCC. Patients were divided into the LRLR and ORLR groups, and their short- and long-term outcomes were compared via PSM.
Results: There were 256 and 130 patients in the ORLR and LRLR groups, respectively. After PSM, 64 patients were included in each group. Intraoperative blood loss was significantly less in LRLR than in ORLR (56 vs 208 ml, P < .001). Postoperative complications of Clavien-Dindo IIIa or more were significantly less in LRLR than in ORLR (3.1% vs 15.6%, P = .030). The length of hospital stay was notably shorter in LRLR than in ORLR (9 vs 12 days, P < .001). Survival rates after repeat liver resection at 1, 3, and 5 years, respectively, were comparable at 93.4%, 81.9%, and 63.5% for ORLR and at 94.8%, 80.7%, and 67.3% for LRLR (P = .623). Subgroup analysis of patients who underwent wedge resection in repeat liver resection revealed that the postoperative complication rate was notably lower in LRLR than in ORLR (7.2% vs 21.8%, P = .030).
Conclusion: LRLR for recurrent HCC is a viable option due to its better short-term outcomes and comparable long-term outcomes compared to ORLR.
(© 2022 Japanese Society of Hepato-Biliary-Pancreatic Surgery.)
Databáze: MEDLINE
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