Laparoscopic Versus Open Hepatic Resection for Solitary Hepatocellular Carcinoma Less Than 5 cm in Cirrhotic Patients: A Randomized Controlled Study

El-Gendi, Ahmed; Elshafei, Mohamed; El-Gendi, Saba; Shawky, Ahmed M.

doi:10.1089/lap.2017.0518

Cited by 74 publications

(45 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It was different from overall survival (p = 0.03) but not different from disease-frees survival (p = 0.2). This indicates that the long-term e cacy of laparoscopic hepatectomy is basically equivalent to that of open hepatectomy, which is basically consistent with the conclusions of other scholars [19][20][21] .…”

Section: Discussionsupporting

confidence: 89%

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

Yuan

Zeng

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

BackgroundHepatocellular carcinoma (HCC) ranks as the fourth most common cancer and the third leading cause of cancer-related mortality worldwide. With the development of minimally invasive surgical techniques, laparoscopic hepatectomy is becoming more prevalent in liver surgery. There are multiple reports to evaluate the safety and feasibility of laparoscopic liver resection. Unfortunately, the jury is still out on whether laparoscopic hepatectomy is better than open hepatectomy. The aim of this study is to compare the perioperative and postoperative long-term outcomes of open hepatectomy and laparoscopic hepatectomy for hepatocellular carcinoma, and to evaluate the safety and efficacy of the two surgical methods for hepatocellular carcinoma.MethodsA prospective cohort study of patients who underwent major hepatectomy for hepatocellular carcinoma between October 2017 and September2018 was performed. And these patients were followed for 24 months after surgery. There are158 patients involved in the present study and they were randomly divided into two groups, LH group (n=60), and OH group (n=98). And all of 158 patients underwent hepatectomy. Continuous data were compared by one-way ANOVA, and categorical data were compared by Fisher’s exact test or the c2 test. Survival curves were calculated by the Kaplan–Meier method and compared using the log-rank test. The study was approved by the ethics committee of Union Hospital. (No. WHUH2018S002) and registered in the International Clinical Trial Registry (No. NCT03585166). Informed consent was signed by all patients.ResultsIncision lengths of LH (5.14±3.11cm) were shorter than OH(20.92±6.44cm), P<0.001. Operating time of LH (398.53±170.51 minutes) were longer than OH(257.74±91.31 minutes), P=0.003. Hospital stay of LH(17.72±5.82 days) were shorter than OH(21.42±8.44 days), P<0.001. The average hospitalization costs of LH group (82741.18±26128.81￥) were significantly less than OH group (94998.75±30499.64￥), p=0.011<0.05. The incidence of total complications was also lower in LH group than in OH group (P<0.001). Postoperatively, the leukocyte was significantly lower at 1st day in LH group (9.79±2.92G/L) than in OH group (12.6±4.85 G/L), p<0.001.The aspartate aminotransferase (AST) was significantly lower at 7th day in LH group (39.25±16.63 U/L) than in OH group (62.49±67.77 U/L), p=0.01<0.05. The albumin was significantly higher at 3rd day in LH group (34.21±3.94 g/L) than in OH group (31.24±5.23 g/L), p<0.001. The albumin was significantly higher at 7th day in LH group (35.26±3.73 g/L) than in OH group (33.31±4.51 g/L), p=0.006<0.05. Direct bilirubin was significantly higher at 1st day in LH group (10.28±10.70 µmol /L) than in OH group (315.03±15.71 µmol /L), p=0.04<0.05. The follow-up time after surgery was 24 months (1-24). The mean follow-up time after surgery was 17.94±9.132. Log rank test was performed to compare overall survival rates between the two groups. There were no statistically significant differences with 2-year survival rate between LH and OH group for liver cancer patients, nor was disease-free survival.ConclusionsLaparoscopic hepatectomy surgery supplied a lower incision lengths, hospital stay and incidence of total complications. Laparoscopic hepatectomy was cheaper the open hepatectomy.There were no statistically significant differences with 2-year survival rate between the two group for liver cancer patients, nor was disease-free survival.

show abstract

Section: Discussionsupporting

confidence: 89%

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

Yuan

Zeng

Tian

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…LLR had comparative resection time (66.56 ± 23.80 min vs. 59.56 ± 14.74 min, P = 0.218), amount of blood loss (250 mL vs. 230 mL, P = 0.915), transfusion rate (P = 1.00), and R0 resection rate when compared with OLR. There was no significant difference between the two groups in terms of postoperative tumor-free survival time [33] . In a Japanese study, information on patients undergoing liver cancer surgery was collected from 31 centers between 2000 and 2010, and divided into LLR (n = 436) and OLR (n = 2969) groups.…”

Section: Laparoscopic Hepatectomymentioning

confidence: 71%

“…However, there is no evidence that patients with liver cancer who undergo laparoscopic liver resection are afforded a better prognosis. In a recent study, Ahmed El-Gendi et al [33] compared the therapeutic effects of OLR with LLR in patients with liver cirrhosis (Child A) with solitary small (< 5 cm) peripheral HCC. The results showed that LLR had significantly less operative time (120.32 ± 21.58 min vs. 146.80 ± 16.59 min, P < 0.001) and shorter duration of hospital stay (2.40 ± 0.58 days vs. 4.28 ± 0.79 days, P < 0.001), with comparable overall complications (25% vs. 28%, P = 0.02).…”

Section: Laparoscopic Hepatectomymentioning

confidence: 99%

Advances in minimally invasive surgery for hepatocellular carcinoma

Zhang¹,

Li²

2020

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third leading cause of cancer-related death worldwide. Surgical resection is still regarded as the first choice of treatment for HCC. With advances in technology and techniques, minimally invasive surgery has now become the standard of care in almost every field in general surgery, including hepatectomy surgery. This review focuses on the latest advances in minimally invasive surgical treatment of HCC, including laparoscopic hepatectomy (LH), robotic hepatectomy (RH) and other minimally invasive treatment technologies. Although some limitation in LH or RH exists, these minimally invasive techniques may be performed for hepatectomy with benefits, and have a promising future. With the development of technology and the improvement of surgical operations, patients will benefit from this.

show abstract

“…First experiences in laparoscopic liver resections for HCC go back over 20 years as reported by Daniel Cherqui in a feasibility study in 30 patients [28]. Meanwhile there is one controlled randomized study (n = 25 vs. n = 25) comparing laparoscopic and open liver resection in early HCC (< 5 cm) in compensated cirrhosis (CHILD A) from Egypt [29]. Operative time and hospital stay were decreased in the laparoscopic group with otherwise comparable perioperative results.…”

Section: Hepatocellular Carcinoma and Liver Cirrhosismentioning

confidence: 97%

Laparoscopic liver resection: indications, limitations, and economic aspects

Schmelzle

Krenzien

Schöning

et al. 2020

Langenbecks Arch Surg

View full text Add to dashboard Cite

Background Minimally invasive techniques have increasingly found their way into liver surgery in recent years. A multitude of mostly retrospective analyses suggests several advantages of laparoscopic over open liver surgery. Due to the speed and variety of simultaneous technical and strategic developments, it is difficult to maintain an overview of the current status and perspectives in laparoscopic liver surgery. Purpose This review highlights up-to-date aspects in laparoscopic liver surgery. We discuss established indications with regard to their development over time as well as continuing limitations of applied techniques. We give an assessment based on the current literature and according to our own center experiences, not least with regard to a highly topical cost discussion. Conclusions While in the beginning mainly benign tumors were laparoscopically operated on, liver metastasis and hepatocellular carcinoma are now among the most frequent indications. Technical limitations remain and should be evaluated with the overall aim not to endanger quality standards in open surgery. Financial aspects cannot be neglected with the necessity of cost-covering reimbursement.

show abstract

Laparoscopic Versus Open Hepatic Resection for Solitary Hepatocellular Carcinoma Less Than 5 cm in Cirrhotic Patients: A Randomized Controlled Study

Abstract: LLR is superior to the OLR with significantly shorter duration of hospital stay and does not compromise the oncological outcomes.

Cited by 74 publications

References 47 publications

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

Laparoscopic hepatectomy versus open hepatectomy for hepatocellular carcinoma in 158 patients: A prospective cohort study

Advances in minimally invasive surgery for hepatocellular carcinoma

Laparoscopic liver resection: indications, limitations, and economic aspects

Contact Info

Product

Resources

About