Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: A case-matched analysis

Lee, Woo Hyung; Han, Ho‐Seong; Yoon, Yoo Seok; Cho, Jai Young; Choi, Yo Won; Shin, Hyungcheol; Jang, Jae Yool; Choi, Hanlim; Jang, Jae Seong; Kwon, Sun U.

doi:10.1016/j.surg.2016.05.009

Cited by 65 publications

(44 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Besides the meticulous dissection and maintaining low level of the central venous pressure during the liver parenchyma dissection, we routinely applied intermittent Pringle maneuver to control surgical blood loss. Differ from the previous series reported, the Pringle maneuver was performed occasionally in the event of major bleeding [ 29 , 30 ], we adopted this technique as routine use because parenchyma transection in the setting of elevated portal pressure and impaired coagulation in cirrhotic patients can be extremely difficult. Under the magnified vision during laparoscopic hepatectomy, a clean surgical field with less blood loss is associated with shorter operative duration.…”

Section: Discussionmentioning

confidence: 99%

Outcomes following laparoscopic versus open major hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score-matched analysis

Liu

et al. 2017

Surg Endosc

View full text Add to dashboard Cite

BackgroundLaparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC) in patients with cirrhosis remains controversial due to limited reports in the literature. This study analyzed the perioperative and oncological outcomes of LMH for HCC with cirrhosis compared with open major hepatectomy (OMH).MethodsA retrospective analysis of patients with cirrhosis who underwent major hepatectomy for HCC between January 2015 and January 2017 was performed. Patients were divided into the LMH group and the OMH group. Short-term and oncological outcomes were compared before and after 1:1 propensity score matching (PSM).ResultsA total of 103 HCC patients who received major liver resection were enrolled. There were 36 (35.0%) patients in the LMH group and 67 (65.0%) patients in the OMH group. After 1:1 PSM, well-matched 32 patients in each group were evaluated. Significant differences were observed in operative time (median, 255 vs. 200 min, p < 0.001) and Pringle time (median, 50 vs. 30 min, p < 0.001) between two groups. The blood loss and transfusion requirement were comparable in two groups. The rate of overall postoperative complications did not differ between two groups, while the incidence of ascites in the LMH group was significantly less than OMH group (9.4 vs. 31.3%, p = 0.030). The oncological outcomes between the two groups were comparable with regard to 2-year overall survival (85.7 vs. 86.7%, p = 0.694) and disease-free survival (72.9 vs. 81.5%, p = 0.990), respectively.ConclusionsLMH for HCC patients with liver cirrhosis showed comparable results in terms of postoperative morbidity and oncological outcomes compared with traditional open procedure. LMH may serve as a safe and feasible alternative for selected HCC patients with cirrhosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Outcomes following laparoscopic versus open major hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score-matched analysis

Liu

et al. 2017

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…Thus, patients who require major or difficult hepatectomy for CRLM may not be able to benefit from the advantages of laparoscopic surgery. Nevertheless, recent reports have indicated that laparoscopic major and difficult hepatectomy is safe and feasible, 28 – 31 and our hospital began performing laparoscopic major and difficult hepatectomy in June 2016, based on the accumulated experience with LH. We hope to generate additional data to examine the utility of laparoscopic major and difficult hepatectomy in future studies.…”

Section: Discussionmentioning

confidence: 99%

Short- and long-term outcomes of laparoscopic hepatectomy for colorectal liver metastases in elderly patients

Yue

Yan

et al. 2018

CMAR

View full text Add to dashboard Cite

PurposeThis study aimed to evaluate the short- and long-term outcomes of laparoscopic hepatectomy (LH) for colorectal liver metastases (CRLM) in elderly patients.Patients and methodsBetween January 2009 and January 2016, LH was performed for 241 consecutive patients who were ≥60 years old and had CRLM. Based on their age at the LH, the patients were divided into an elderly group (≥70 years old, 78 patients) and a middle-aged group (60–69 years old, 163 patients). The short- and long-term outcomes were compared between the two groups.ResultsCompared to the middle-aged group, the elderly group had higher values for Charlson comorbidity index, proportion of preoperative chemotherapy, and American Society of Anesthesiologists score. No other significant differences were observed in the preoperative characteristics. The elderly group had a higher conversion rate, compared to the middle-aged group, although no significant differences were observed in the surgical procedures, surgical times, intraoperative blood losses, numbers and severities of postoperative 90-day complications, postoperative 90-day mortality rates, pathology results, and other short-term outcomes. Long-term follow-up revealed similar rates of recurrence, disease-free survival, and overall survival in the two groups. Multivariable analysis revealed that age did not independently predict overall survival or disease-free survival.ConclusionSimilar short- and long-term outcomes were observed after LH for CRLM in elderly and middle-aged patients. Thus, advanced age is not a contraindication for LH treatment in this setting.

show abstract

“…Minor LLRs in segment 1, 4a, 7 and 8 are associated with greater operative time and blood loss than equivalent resections in the anterolateral segments. However, mortality and morbidity is not different (46). Compared to OLR, LLR is associated with reduced blood loss and hospital stay (47) .…”

Section: What Is the Role Of The Laparoscopic Technique For Liver Resmentioning

confidence: 99%

The Southampton Consensus Guidelines for Laparoscopic Liver Surgery

Aldrighetti²,

et al. 2018

View full text Add to dashboard Cite

The European Guidelines Meeting for Laparoscopic Liver Surgery has produced a set of clinical practice guidelines that have been independently validated for the safe development and progression of laparoscopic liver surgery. The Southampton Guidelines have amalgamated the available evidence and a wealth of experts' knowledge taking in consideration the relevant stakeholders' opinions and complying with the international methodology standards.

show abstract

Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: A case-matched analysis

Cited by 65 publications

References 27 publications

Outcomes following laparoscopic versus open major hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score-matched analysis

Outcomes following laparoscopic versus open major hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score-matched analysis

Short- and long-term outcomes of laparoscopic hepatectomy for colorectal liver metastases in elderly patients

The Southampton Consensus Guidelines for Laparoscopic Liver Surgery

Contact Info

Product

Resources

About