Laparoscopic repeat liver resection for hepatocellular carcinoma: a multicentre propensity score-based study
Author:
Morise Z1ORCID, Aldrighetti L2ORCID, Belli G3, Ratti F2ORCID, Belli A4, Cherqui D5, Tanabe M6, Wakabayashi G7, Cheung T T, Lo C M, Tanaka S, Kubo S, Okamura Y, Uesaka K, Monden K, Sadamori H, Hashida K, Kawamoto K, Gotohda N, Chen K H, Kanazawa A, Takeda Y, Ohmura Y, Ueno M, Ogura T, Suh K S, Kato Y, Sugioka A, Nitta H, Yasunaga M, Halium N A, Laurent A, Kaneko H, Otsuka Y, Kim K H, Cho H-D, Lin C C-W, Ome Y, Seyama Y, Troisi R I, Berardi G, Roteller F, Wilson G C, Geller D A, Soubrane O, Yoh T, Kaizu T, Kumamoto Y, Han H-S, Ekmekcigil E, Dagher I, Fuks D, Gayet B, Buell J F, Ciria R, Briceno J, O'Rourke N, Lewin J, Edwin B, Shinoda M, Abe Y, Hilal M Abu, Alzoubi M
Affiliation:
1. Department of General Surgery, Fujita Health University School of Medicine, Bantane Hospital, Aichi, Japan 2. Hepatobiliary Division, Department of Surgery, San Raffaele Hospital, Milan, Italy 3. Department of General and Hepatopancreatobiliary Surgery, Loreto Nuovo Hospital, Naples, Italy 4. Department of Abdominal Surgical Oncology, Fondazione G. Pascale–Istituto di Ricovero e Cura a Carattere Scientifico, National Cancer Institute of Naples, Naples, Italy 5. Hepatobiliary Centre, Paul Brousse Hospital, Villejuif, France 6. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan 7. Department of Surgery, Ageo Central General Hospital, Ageo, Japan
Abstract
AbstractBackgroundIn the absence of randomized controlled data and even propensity-matched data, indications for, and outcomes of, laparoscopic repeat liver resection for hepatocellular carcinoma (HCC) remain uncertain. This study aimed to clarify the current indications for laparoscopic repeat liver resection for HCC, and to evaluate outcomes.MethodsForty-two liver surgery centres around the world registered patients who underwent repeat liver resection for HCC. Patient characteristics, preoperative liver function, tumour characteristics, surgical method, and short- and long-term outcomes were recorded.ResultsAnalyses showed that the laparoscopic procedure was generally used in patients with relatively poor performance status and liver function, but favourable tumour characteristics. Intraoperative blood loss (mean(s.d.) 254(551) versus 748(1128) ml; P < 0·001), duration of operation (248(156) versus 285(167) min; P < 0·001), morbidity (12·7 versus 18·1 per cent; P = 0·006) and duration of postoperative hospital stay (10·1(14·3) versus 11·8(11·8) days; P = 0·013) were significantly reduced for laparoscopic compared with open procedures, whereas survival time was comparable (median 10·04 versus 8·94 years; P = 0·297). Propensity score matching showed that laparoscopic repeat liver resection for HCC resulted in less intraoperative blood loss (268(730) versus 497(784) ml; P = 0·001) and a longer operation time (272(187) versus 232(129); P = 0·007) than the open approach, and similar survival time (12·55 versus 8·94 years; P = 0·086).ConclusionLaparoscopic repeat liver resection is feasible in selected patients with recurrent HCC.
Publisher
Oxford University Press (OUP)
Cited by
59 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|