Laparoscopic and open liver resection for hepatocellular carcinoma with Child-Pugh B cirrhosis: multicentre propensity score-matched study
| Autor: | Tan To Cheung, Roberto Montalti, Mariano Cesare Giglio, Annamaria Ferrero, Gregory C. Wilson, Nadia Russolillo, Masayuki Yamamoto, Hironori Kaneko, Chung-Yip Chan, Vincenzo Mazzaferro, Federica Cipriani, Roberto Troisi, I. Simonelli, Luca Aldrighetti, Guido Torzilli, H.-S. Han, K. Igarashi, S. Ariizumi, Shoji Kubo, Zenichi Morise, Matteo Cimino, Brian K. P. Goh, Carlo Sposito, Giuseppe Maria Ettorre, Go Wakabayashi, Sayaka Tanaka, V. Panetta, Giammauro Berardi, Daniel A. Geller, A. Kanazawa, S. Kim, Y. Takeda |
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| Přispěvatelé: | Troisi, R. I., Berardi, G., Morise, Z., Cipriani, F., Ariizumi, S., Sposito, C., Panetta, V., Simonelli, I., Kim, S., Goh, B. K. P., Kubo, S., Tanaka, S., Takeda, Y., Ettorre, G. M., Russolillo, N., Wilson, G. C., Cimino, M., Montalti, R., Giglio, M. C., Igarashi, K., Chan, C. -Y., Torzilli, G., Cheung, T. T., Mazzaferro, V., Kaneko, H., Ferrero, A., Geller, D. A., Han, H. -S., Kanazawa, A., Wakabayashi, G., Aldrighetti, L., Yamamoto, M. |
| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Male Cirrhosis Blood Loss Surgical Severity of Illness Index 0302 clinical medicine Retrospective Studie Ascites Laparoscopy Aged 80 and over medicine.diagnostic_test Liver Neoplasms Middle Aged Prognosis Liver Neoplasm 030220 oncology & carcinogenesis Hepatocellular carcinoma Portal hypertension 030211 gastroenterology & hepatology Female Survival Analysi medicine.symptom Human Adult medicine.medical_specialty Carcinoma Hepatocellular Prognosi Liver Cirrhosi Preoperative care Disease-Free Survival 03 medical and health sciences Young Adult Hypertension Portal medicine Hepatectomy Humans Propensity Score Survival rate Aged Retrospective Studies business.industry Retrospective cohort study Length of Stay medicine.disease Survival Analysis Surgery business |
| Zdroj: | The British journal of surgery. 108(2) |
| ISSN: | 1365-2168 |
| Popis: | Background Laparoscopic liver resection for hepatocellular carcinoma (HCC) in Child–Pugh A cirrhosis has been demonstrated as beneficial. However, the role of laparoscopy in Child–Pugh B cirrhosis is undetermined. The aim of this retrospective cohort study was to compare open and laparoscopic resection for HCC with Child–Pugh B cirrhosis. Methods Data on liver resections were gathered from 17 centres. A 1 : 1 propensity score matching was performed according to 17 predefined variables. Results Of 382 available liver resections, 100 laparoscopic and 100 open resections were matched and analysed. The 90-day postoperative mortality rate was similar in open and laparoscopic groups (4.0 versus 2.0 per cent respectively; P = 0.687). Laparoscopy was associated with lower blood loss (median 110 ml versus 400 ml in the open group; P = 0.004), less morbidity (38.0 versus 51.0 per cent respectively; P = 0.041) and fewer major complications (7.0 versus 21.0 per cent; P = 0.010), and ascites was lower on postoperative days 1, 3 and 5. For laparoscopic resections, patients with portal hypertension developed more complications than those without (26 versus 12 per cent respectively; P = 0.002), and patients with a Child–Pugh B9 score had higher morbidity rates than those with B8 and B7 (7 of 8, 10 of 16 and 21 of 76 respectively; P Conclusion Patients without preoperative portal hypertension and Child–Pugh B7 cirrhosis may benefit most from laparoscopic liver surgery. |
| Databáze: | OpenAIRE |
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