Impact of liver cirrhosis, severity of cirrhosis and portal hypertension on the difficulty of laparoscopic and robotic minor liver resections for primary liver malignancies in the anterolateral segments.

Autor: Zheng J; Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China., Liang X; Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. Electronic address: srrshlx@zju.edu.cn., Wu AGR; Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Kabir T; Department of General Surgery, Sengkang General Hospital, Singapore., Scatton O; Department of Digestive, HBP and Liver Transplantation, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France., Lim C; Department of Digestive, HBP and Liver Transplantation, Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France., Hasegawa K; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan., Sijberden JP; Department of Surgery, Fondazione Poliambulanza, Brescia, Italy., Aghayan DL; The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Siow TF; Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan., Dokmak S; Department of HPB Surgery and Liver Transplantation, Beaujon Hospital, University Paris Cite, Clichy, France., Herman P; Liver Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil., Marino MV; General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy; General Surgery Department, F. Tappeiner Hospital, Merano, Italy., Mazzaferro V; HPB Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori di Milano and University of Milan, Milan, Italy., Chiow AKH; Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore., Sucandy I; Digestive Health Institute, AdventHealth Tampa, Tampa, FL, USA., Ivanecz A; Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia., Choi SH; Department of General Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea., Lee JH; Department of Surgery, Division of Hepato-Biliary and Pancreatic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea., Prieto M; Hepatobiliary Surgery and Liver Transplantation Unit, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Bilbao, Spain., Vivarelli M; HPB Surgery and Transplantation Unit, United Hospital of Ancona, Department of Experimental and Clinical Medicine Polytechnic University of Marche, Ancona, Italy., Giuliante F; Hepatobiliary Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Catholic University of the Sacred Heart, Rome, Italy., Ruzzenente A; General and Hepatobiliary Surgery, Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, GB Rossi Hospital, Verona, Italy., Yong CC; Department of Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan., Yin M; Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China., Chen Z; Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China., Fondevila C; General and Digestive Surgery, Hospital Clinic, IDIBAPS, CIBERehd, University of Barcelona, Barcelona, Spain; General and Digestive Surgery, Hospital Universitario La Paz, IdiPAZ, CIBERehd, Madrid, Spain., Efanov M; Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia., Morise Z; Department of Surgery, Okazaki Medical Center, Fujita Health University School of Medicine, Okazaki, Japan., Di Benedetto F; HPB Surgery and Liver Transplant Unit, University of Modena and Reggio Emilia, Modena, Italy., Brustia R; Department of Digestive and Hepatobiliary and Pancreatic Surgery, AP-HP, Henri-Mondor Hospital, Creteil, France., Dalla Valle R; Hepatobiliary Surgery Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy., Boggi U; Division of General and Transplant Surgery, University of Pisa, Pisa, Italy., Geller D; Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Belli A; Department of Abdominal Oncology, Division of Hepatopancreatobiliary Surgical Oncology, National Cancer Center - IRCCS-G. Pascale, Naples, Italy., Memeo R; Unit of Hepato-Pancreatc-Biliary Surgery, 'F. Miulli' General Regional Hospital, Acquaviva Delle Fonti, Bari, Italy., Gruttadauria S; Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto Mediterraneo per I Trapianti e Terapie Ad Alta Specializzazione (IRCCS-ISMETT), University of Pittsburgh Medical Center Italy, Palermo, Italy; Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy., Mejia A; The Liver Institute, Methodist Dallas Medical Center, Dallas, TX, USA., Park JO; Department of Surgery, University of Washington Medical Center, Seattle, USA., Rotellar F; HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain., Choi GH; Division of Hepatopancreatobiliary Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea; Institute of Health Research of Navarra (IdisNA), Pamplona, Spain., Robles-Campos R; Department of General, Visceral and Transplantation Surgery, Clinic and University Hospital Virgen de La Arrixaca, IMIB-ARRIXACA, El Palmar, Murcia, Spain., Wang X; Department of Liver Surgery and Transplantation, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China., Sutcliffe RP; Department of Hepatopancreatobiliary and Liver Transplant Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom., Pratschke J; Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, And Berlin Institute of Health, Berlin, Germany., Lai ECH; Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region., Chong CCN; Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong Special Administrative Region., D'Hondt M; Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, Kortrijk, Belgium., Monden K; Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan., Lopez-Ben S; Hepatobiliary and Pancreatic Surgery Unit, Department of Surgery, Dr. Josep Trueta Hospital, IdIBGi, Girona, Spain., Kingham TP; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Ferrero A; Department of General and Oncological Surgery. Mauriziano Hospital, Turin, Italy., Ettorre GM; Division of General Surgery and Liver Transplantation, San Camillo Forlanini Hospital, Rome, Italy., Cherqui D; Department of Hepatobiliary Surgery, Assistance Publique Hopitaux de Paris, Centre Hepato-Biliaire, Paul-Brousse Hospital, Villejuif, France., Cipriani F; Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy., Soubrane O; Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France., Zhang W; Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China., Wakabayashi G; Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan., Troisi RI; Department of Clinical Medicine and Surgery, Division of HPB, Minimally Invasive and Robotic Surgery, Federico II University Hospital Naples, Naples, Italy., Cheung TT; Department of Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong Special Administrative Region., Kato Y; Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan., Sugioka A; Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan., Long TCD; Department of Hepatopancreatobiliary Surgery, University Medical Center, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam., Liu R; Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China., Edwin B; The Intervention Centre and Department of HPB Surgery, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway., Fuks D; Department of Digestive, Oncologic and Metabolic Surgery, Institute Mutualiste Montsouris, Universite Paris Descartes, Paris, France., Abu Hilal M; Department of Surgery, Fondazione Poliambulanza, Brescia, Italy; Department of Surgery, University Hospital Southampton, United Kingdom., Chen KH; Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan., Aldrighetti L; Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy., Han HS; Department of Surgery, Seoul National University Hospital Bundang, Seoul National University College of Medicine, Seoul, South Korea., Goh BKP; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore; Surgery Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore. Electronic address: bsgkp@hotmail.com.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Jan; Vol. 50 (1), pp. 107252. Date of Electronic Publication: 2023 Nov 08.
DOI: 10.1016/j.ejso.2023.107252
Abstrakt: Introduction: We performed this study in order to investigate the impact of liver cirrhosis (LC) on the difficulty of minimally invasive liver resection (MILR), focusing on minor resections in anterolateral (AL) segments for primary liver malignancies.
Methods: This was an international multicenter retrospective study of 3675 patients who underwent MILR across 60 centers from 2004 to 2021.
Results: 1312 (35.7%) patients had no cirrhosis, 2118 (57.9%) had Child A cirrhosis and 245 (6.7%) had Child B cirrhosis. After propensity score matching (PSM), patients in Child A cirrhosis group had higher rates of open conversion (p = 0.024), blood loss >500 mls (p = 0.001), blood transfusion (p < 0.001), postoperative morbidity (p = 0.004), and in-hospital mortality (p = 0.041). After coarsened exact matching (CEM), Child A cirrhotic patients had higher open conversion rate (p = 0.05), greater median blood loss (p = 0.014) and increased postoperative morbidity (p = 0.001). Compared to Child A cirrhosis, Child B cirrhosis group had longer postoperative stay (p = 0.001) and greater major morbidity (p = 0.012) after PSM, and higher blood transfusion rates (p = 0.002), longer postoperative stay (p < 0.001), and greater major morbidity (p = 0.006) after CEM. After PSM, patients with portal hypertension experienced higher rates of blood loss >500 mls (p = 0.003) and intraoperative blood transfusion (p = 0.025).
Conclusion: The presence and severity of LC affect and compound the difficulty of MILR for minor resections in the AL segments. These factors should be considered for inclusion into future difficulty scoring systems for MILR.
Competing Interests: Declaration of competing interest
(©2023 Published by Elsevier Ltd.)
Databáze: MEDLINE
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