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Surgical Endoscopy
Published in: Surgical Endoscopy 2/2015

01-02-2015

Short- and long-term outcomes of laparoscopic versus open hepatectomy for small malignant liver tumors: a single-center experience

Authors: Fumitoshi Hirokawa, Michihiro Hayashi, Yoshiharu Miyamoto, Mitsuhiro Asakuma, Tetsunosuke Shimizu, Koji Komeda, Yoshihiro Inoue, Kazuhisa Uchiyama

Published in: Surgical Endoscopy | Issue 2/2015

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Abstract

Background

Laparoscopic hepatectomy (Lap-Hx) has been increasingly performed for patients with liver tumors as surgical techniques and devices have progressed. However, the long-term outcomes of Lap-Hx for malignant liver tumors are not oncologically guaranteed. This study compared the short- and long-term outcomes between Lap-Hx and open hepatectomy (Open-Hx) for malignant liver tumors by matched-pair analysis.

Methods

The indications for Lap-Hx at our department are a tumor size of <5 cm and fewer than two lesions without macroscopic vascular invasion or the need for biliary reconstruction. In total, 135 patients underwent Lap-Hx for malignant liver tumors through December 2013. We compared the short- and long-term outcomes between Lap-Hx and Open-Hx in patients who met the above-mentioned indications.

Results

With respect to short-term outcomes, the operation time, blood loss, postoperative hospital stay, white blood cell count, and C-reactive protein level after Lap-Hx were significantly better than those after Open-Hx in both the patients who underwent partial resection and those who underwent lateral sectionectomy. In patients who underwent partial resection, the incidence of postoperative complications after Lap-Hx was significantly lower than that after Open-Hx; in particular, wound infection and respiratory complications were significantly lower. Furthermore, when the tumor was located in the posterosuperior segments, the operation time for Lap-Hx was not shorter than that for Open-Hx. With respect to long-term outcomes of hepatocellular carcinoma, neither overall nor disease-free survival differed between the two groups. With respect to long-term outcomes of colorectal liver metastases, the disease-free survival rate was similar between Lap-Hx and Open-Hx; however, the overall survival rate was significantly better for Lap-Hx than for Open-Hx.

Conclusions

Lap-Hx is a good option for selected patients with malignant liver tumors. The short- and long-term outcomes of Lap-Hx also are considered to be acceptable.
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Metadata
Title
Short- and long-term outcomes of laparoscopic versus open hepatectomy for small malignant liver tumors: a single-center experience
Authors
Fumitoshi Hirokawa
Michihiro Hayashi
Yoshiharu Miyamoto
Mitsuhiro Asakuma
Tetsunosuke Shimizu
Koji Komeda
Yoshihiro Inoue
Kazuhisa Uchiyama
Publication date
01-02-2015
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 2/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-014-3687-3

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