Top

World Journal of Surgery

Published in:

01-09-2018 | Original Scientific Report

Laparoscopic Versus Open Right Posterior Sectionectomy for Hepatocellular Carcinoma in a High-Volume Center: A Propensity Score Matched Analysis

Authors: Jinsoo Rhu, Sung Joo Kim, Gyu Seong Choi, Jong Man Kim, Jae-Won Joh, Choon Hyuck David Kwon

Published in: World Journal of Surgery | Issue 9/2018

Abstract

Background

While minimal invasive surgery is becoming popular in liver resection, right posterior sectionectomy (RPS) is still considered as a difficult procedure. We summarize the clinical data and investigate the feasibility of laparoscopic right posterior sectionectomy (LRPS) in hepatocellular carcinoma (HCC) by comparing its outcomes with those of open right posterior sectionectomy (ORPS).

Methods

We retrospectively reviewed 191 patients who underwent RPS for HCC during January 2009 to August 2016 at Samsung Medical Center. After 1:2 propensity score matching, 53 patients in LRPS group were matched to 97 patients in ORPS group.

Results

There was no statistical difference in preoperative data. While operation time was significantly longer in LRPS group (381.1 ± 118.7 vs. 234.4 ± 63.7 min, P < 0.001), transfusion rate (13.2 vs. 2.1%, P = 0.061) and complication rate (9.4 vs. 8.3%, P = 0.709) were not statistically different between groups. Clustered Cox proportional hazards regression analysis for matched paired data showed no difference in both disease-free survival (P = 0.607) and overall survival (P = 0.858).

Conclusions

In HCC, LRPS can be performed safely compared to ORPS, regarding the operative outcome, patient recovery, and oncological outcomes.

Grazi GL, Ercolani G, Pierangeli F et al (2001) Improved results of liver resection for hepatocellular carcinoma on cirrhosis give the procedure added value. Ann Surg 234:71–78CrossRefPubMedPubMedCentral

Regimbeau JM, Kianmanesh R, Farges O et al (2002) Extent of liver resection influences the outcome in patients with cirrhosis and small hepatocellular carcinoma. Surgery 131:311–317CrossRefPubMed

Bryant R, Laurent A, Tayar C et al (2009) Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience. Ann Surg 250:103–111CrossRefPubMed

Cheung TT, Poon RT, Yuen WK et al (2013) Long-term survival analysis of pure laparoscopic versus open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a single-center experience. Ann Surg 257:506–511CrossRefPubMed

Tranchart H, Di Giuro G, Lainas P et al (2010) Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg Endosc 24:1170–1176CrossRefPubMed

Cho JY, Han HS, Yoon YS et al (2009) Outcomes of laparoscopic liver resection for lesions located in the right side of the liver. Arch Surg 144:25–29CrossRefPubMed

Gigot JF, Glineur D, Santiago Azagra J et al (2002) Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study. Ann Surg 236:90–97CrossRefPubMedPubMedCentral

Kaneko H, Takagi S, Shiba T (1996) Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery 120:468–475CrossRefPubMed

Buell JF, Cherqui D, Geller DA et al (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830CrossRefPubMed

10.

Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed

11.

Kang SH, Kim KH, Shin MH et al (2016) Surgical outcomes following laparoscopic major hepatectomy for various liver diseases. Medicine (Baltimore) 95:e5182CrossRefPubMedCentral

12.

Yoon YI, Kim KH, Kang SH et al (2017) Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg 265(5):856–863. https://doi.org/10.1097/SLA.0000000000002072 CrossRefPubMed

13.

Yoon YS, Han HS, Choi YS et al (2006) Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A 16:274–277CrossRefPubMed

14.

Cho JY, Han HS, Yoon YS et al (2015) Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery. Surgery 158:135–141CrossRefPubMed

15.

Lee W, Han HS, Yoon YS et al (2016) Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: a case-matched analysis. Surgery 160:1219–1226CrossRefPubMed

16.

Ban D, Kudo A, Ito H et al (2015) The difficulty of laparoscopic liver resection. Updates Surg 67:123–128CrossRefPubMed

17.

Ban D, Tanabe M, Ito H et al (2014) A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21:745–753CrossRefPubMed

18.

Wakabayashi G (2016) What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary Surg Nutr 5:281–289CrossRefPubMedPubMedCentral

19.

Cho JY, Han HS, Yoon YS et al (2008) Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver. Surg Endosc 22:2344–2349CrossRefPubMed

20.

Costi R, Capelluto E, Sperduto N et al (2003) Laparoscopic right posterior hepatic bisegmentectomy (segments VII–VIII). Surg Endosc 17:162PubMed

21.

Gumbs AA, Gayet B (2008) Video: the lateral laparoscopic approach to lesions in the posterior segments. J Gastrointest Surg 12:1154CrossRefPubMed

22.

Lee N, Cho CW, Kim JM et al (2017) Application of temporary inflow control of the Glissonean pedicle method provides a safe and easy technique for totally laparoscopic hemihepatectomy by Glissonean approach. Ann Surg Treat Res 92:383–386CrossRefPubMedPubMedCentral

23.

Austin PC (2008) A critical appraisal of propensity-score matching in the medical literature between 1996 and 2003. Stat Med 27:2037–2049CrossRefPubMed

24.

Austin PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res 46:399–424CrossRefPubMedPubMedCentral

25.

Normand ST, Landrum MB, Guadagnoli E et al (2001) Validating recommendations for coronary angiography following acute myocardial infarction in the elderly: a matched analysis using propensity scores. J Clin Epidemiol 54:387–398CrossRefPubMed

26.

Jung KU, Kim HC, Cho YB et al (2014) Outcomes of simultaneous laparoscopic colorectal and hepatic resection for patients with colorectal cancers: a comparative study. J Laparoendosc Adv Surg Tech A 24:229–235CrossRefPubMed

27.

Lee S, Hyuck David Kwon C, Man Kim J et al (2014) Time of hepatocellular carcinoma recurrence after liver resection and alpha-fetoprotein are important prognostic factors for salvage liver transplantation. Liver Transpl 20:1057–1063CrossRefPubMed

28.

Rhu J, Heo JS, Choi SH et al (2017) Streamline flow of the portal vein affects the lobar distribution of colorectal liver metastases and has a clinical impact on survival. Ann Surg Treat Res 92:348–354CrossRefPubMedPubMedCentral

Title: Laparoscopic Versus Open Right Posterior Sectionectomy for Hepatocellular Carcinoma in a High-Volume Center: A Propensity Score Matched Analysis
Authors: Jinsoo Rhu
Sung Joo Kim
Gyu Seong Choi
Jong Man Kim
Jae-Won Joh
Choon Hyuck David Kwon
Publication date: 01-09-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 9/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4531-z

At a glance: The STEP trials

Springer Medicine

Laparoscopic Versus Open Right Posterior Sectionectomy for Hepatocellular Carcinoma in a High-Volume Center: A Propensity Score Matched Analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2018

Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya When No Anesthetist is Available: Reply

Is Palliative Percutaneous Drainage for Malignant Biliary Obstruction Useful?

Data Improvement Through Simplification: Implications for Low-Resource Settings

Hospital Teaching Status and Medicare Expenditures for Hepato-Pancreato-Biliary Surgery

Prophylactic Central Neck Dissection for Papillary Thyroid Carcinoma with Clinically Uninvolved Central Neck Lymph Nodes: A Systematic Review and Meta-analysis

Authors’ Reply: Postoperative Bleeding After Laparoscopic Pancreaticoduodenectomy: The Achilles’ Heel?