Minimally Invasive Versus Open Liver Resection for Hepatocellular Carcinoma in the Setting of Portal Vein Hypertension: Results of an International Multi-institutional Analysis
| Autor: | Andrea Ruzzenente, Olivier Soubrane, Francesca Ratti, Aklile Workneh, Itaru Endo, Luca Aldrighetti, Eliza W. Beal, George A. Poultsides, Timothy M. Pawlik, Vincent Lam, Irinel Popescu, Alfredo Guglielmi, Guillaume Martel, Sorin Alexandrescu, Silvia Silva, Thomas J. Hugh, Fabio Bagante, Kota Sahara, Laura Alaimo, Eleftherios Makris, Hugo Marques |
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| Přispěvatelé: | Ruzzenente, A., Bagante, F., Ratti, F., Alaimo, L., Marques, H. P., Silva, S., Soubrane, O., Endo, I., Sahara, K., Beal, E. W., Lam, V., Poultsides, G. A., Makris, E. A., Popescu, I., Alexandrescu, S., Martel, G., Workneh, A., Hugh, T. J., Guglielmi, A., Aldrighetti, L., Pawlik, T. M. |
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular endocrine system diseases Hepatocellular carcinoma Portal venous pressure Portal vein Gastroenterology 03 medical and health sciences 0302 clinical medicine Text mining Surgical oncology Internal medicine Hypertension Portal otorhinolaryngologic diseases Carcinoma medicine Hepatectomy Humans Minimally Invasive Surgical Procedures Aged Retrospective Studies Open liver resection Platelet Count Portal Vein business.industry Liver Neoplasms Retrospective cohort study Middle Aged medicine.disease Portal Pressure Thrombocytopenia Treatment Outcome Oncology 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery business |
| Zdroj: | Annals of Surgical Oncology. 27:3360-3371 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-020-08444-3 |
| Popis: | Background: Patients with hepatocellular carcinoma (HCC) and portal vein hypertension assessed with platelet count (PVH-PLT; platelet count < 100,000/mL) are often denied surgery even when the disease is technically resectable. Short- and long-term outcomes of patients undergoing minimally invasive surgery (MIS) versus open resection for HCC and PVH-PLT were compared. Methods: Propensity score matching (PSM) was used to balance the clinicopathological differences between MIS and non-MIS patents. Univariate comparison and standard survival analyses were utilized. Results: Among 1974 patients who underwent surgery for HCC, 13% had a PVH-PLT and 33% underwent MIS. After 1:1 PSM, 407 MIS and 407 non-MIS patients were analyzed. Incidence of complications and length-of-stay (LoS) were higher among non-MIS versus MIS patients (both p ≤ 0.002). After PSM, among 178 PVH-PLT patients (89 MIS and 89 non-MIS), patients who underwent anon-MIS approach had longer LoS (> 7days; non-MIS: 55% vs. MIS: 29%), as well as higher morbidity (non-MIS: 42% vs. MIS: 29%) [p |
| Databáze: | OpenAIRE |
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