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01-05-2019

Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Authors: Giovanni Battista Levi Sandri, Giuseppe Maria Ettorre, Luca Aldrighetti, Umberto Cillo, Raffaele Dalla Valle, Alfredo Guglielmi, Vincenzo Mazzaferro, Alessandro Ferrero, Fabrizio Di Benedetto, Salvatore Gruttadauria, Luciano De Carlis, Giovanni Vennarecci, I Go MILS Group on HCC

Published in: Surgical Endoscopy | Issue 5/2019

Abstract

Objective

Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality.

Methods

38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1.

Results

Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS.

Conclusions

These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.

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Title: Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry
Authors: Giovanni Battista Levi Sandri
Giuseppe Maria Ettorre
Luca Aldrighetti
Umberto Cillo
Raffaele Dalla Valle
Alfredo Guglielmi
Vincenzo Mazzaferro
Alessandro Ferrero
Fabrizio Di Benedetto
Salvatore Gruttadauria
Luciano De Carlis
Giovanni Vennarecci
I Go MILS Group on HCC
Publication date: 01-05-2019
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 5/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6426-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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