Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis

Kanazawa, Akira; Tsukamoto, Tadashi; Shimizu, Satoshi; Kodai, Shintaro; Yamazoe, Sadaaki; Yamamoto, Satoshi; Kubo, Shoji

doi:10.1007/s00464-013-2795-9

Cited by 101 publications

(68 citation statements)

References 20 publications

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“…Laparoscopic approaches to diaphragmatic repair have been introduced in the elective setting [10,18]. The laparoscopic approach is widely accepted as the safer surgical approach in patients with HCC and cirrhosis reducing ascites or pleural effusion than conventional laparotomy [23]. In addition to reducing the risk of postoperative complications due to liver cirrhosis, a laparoscopic approach also provides a better intraoperative view than an open procedure.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report

Yamamoto¹,

Sugiura²,

Okamura³

et al. 2017

J Clin Case Rep

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report

Yamamoto¹,

Sugiura²,

Okamura³

et al. 2017

J Clin Case Rep

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“…However, in selected patients who undergo surgery by experienced hands, one of the most important advantage of the laparoscopic approach is the potential improvement in terms of blood loss and transfusion rates [4][5][6][7][8][9][10][11]. This specific improvement of the laparoscopic approach in comparison to open surgery was particularly underlined by the experts at the Morioka consensus.…”

Section: Discussionmentioning

confidence: 99%

“…), bleeding control during laparoscopic liver resection (LLR) is a liverspecific improvement, which has been underlined by many experts [4][5][6][7][8][9][10][11]. Several studies aimed to elucidate the factors responsible for reduced blood loss during laparoscopic liver surgery.…”

Section: Introductionmentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

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Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

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“…The estimated 3-year survival for patients with untreated stage B HCC ranges from 8% to 50%; given the invasiveness of surgery, palliation with TACE is therefore recommended for these subset of patients [9] . However, TACE cannot induce complete tumor necrosis especially in large tumors, with reported response rates in literature as low as 2% [8,10] . Liver resection, based on the BCLC system, is usually reserved for patients with small, single tumors, with absence of portal hypertension or hyperbilirubinemia [9] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of outcomes between laparoscopic vs. open liver resection for intermediate stage hepatocellular carcinoma

David¹,

Choi²,

Han³

et al. 2018

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Aim: The Barcelona Clinic Liver Score (BCLC) currently limits hepatic resection only for small, solitary tumors measuring 2-3 cm with no signs of portal hypertension (PHT) or macrovascular invasion. The aim of this study was to show the benefit of surgical resection, and to compare the peri-operative and long-term outcomes between laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma (HCC) classified as intermediate stage (B) under BCLC. Methods: From 2004 to 2013, 49 patients staged as intermediate (BCLC B)and who underwent hepatic resection was included. These patients were divided into LLR or OLR. Demographics, tumor characteristics, recurrence rates and overall survival (OS) were compared between the 2 groups.Results: Forty-nine patients were included and grouped into LLR (n = 28) and OLR (n = 21). The average tumor number was 2 ± 1 for both groups, while the mean tumor size was 4.4 ± 1.7 cm and 5.3 ± 2.6 cm for the LLR and OLR group, respectively. When compared with OLR, LLR had lower post-operative complications (14.3% vs. 33.3%, P = 0.114), and a statistically significant shorter hospital stay than the OLR group (9 vs. 21 days, P = 0.023).The LLR group also achieved a statistically significant difference in complete R0 resection as compared with the OLR group (P = 0.016). The OS and disease-free survival (DFS) at 1, 3 and 5 years were comparable between LLR and OLR (OS: 89.1% vs. 76.2%; 70.4% vs. 55.9%; 58.6% vs. 43.5%, P = 0.583; DFS: 59.3% vs. 51.0%; 20.2% vs. 44.6%; 16.2% vs. 37.2%, P = 0.947, respectively). Conclusion:LLR showed comparable outcomes compared to OLR in the treatment of HCC staged BCLC B. Therefore, LLR as well as OLR can be considered in selective patients in the BCLC B group.

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Impact of laparoscopic liver resection for hepatocellular carcinoma with F4-liver cirrhosis

Cited by 101 publications

References 20 publications

Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report

Laparoscopic Repair of Diaphragmatic Perforation with Colonic Herniation Following Hepatic Radiofrequency Ablation: A Case Report

Bleeding control during laparoscopic liver resection: a review of literature

Comparison of outcomes between laparoscopic vs. open liver resection for intermediate stage hepatocellular carcinoma

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