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Surgical Endoscopy

Published in:

01-10-2015

Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments

Authors: Le Xiao, Lun-jian Xiang, Jian-wei Li, Jian Chen, Yu-dong Fan, Shu-guo Zheng

Published in: Surgical Endoscopy | Issue 10/2015

Abstract

Background

Traditional open liver resection remains the classic procedure for hepatocellular carcinoma (HCC) located in the posterosuperior segments of the liver (segments I, IVa, VII, and VIII). This study compared the perioperative and oncologic results for laparoscopic versus open liver resection of HCC located in the posterosuperior segments, especially in patients with cirrhosis.

Methods

This study included 41 patients who underwent laparoscopic liver resection (LLR) and 86 who underwent open liver resection (OLR) for HCC in the posterosuperior segments between January 1, 2010, and December 31, 2012. There perioperative course and oncologic outcomes were retrospectively evaluated.

Results

There were no significant differences between the LLR and OLR groups in length of operation (242.41 ± 73.69 vs. 235.38 ± 65.80 min), transfusion rate (7.3 vs. 14.0 %), R0 resection rate (100 vs. 97.7 %), or tumor size (4.22 ± 2.05 vs. 4.30 ± 1.49 cm). In contrast, postoperative hospital stay (9.44 ± 2.72 vs. 14.53 ± 6.03 days) was significantly shorter, and postoperative complication rates (17.1 vs. 37.2 %) and intraoperative blood loss (272.20 ± 170.86 vs. 450.12 ± 344.70 mL) significantly lower in the LLR than in the OLR group. In addition, there was no significant difference between the two groups (LLR vs. OLR) regarding 1-year overall survival rate (95.1 vs. 89.5 %), 3-year overall survival rate (78 vs. 76.7 %,), 1-year disease-free survival rate (87.8 vs. 82.6 %,), and 3-year disease-free survival rate (70.7 vs. 68.6 %).

Conclusions

LLR for selected patients with HCC in the posterosuperior segments may offer the same oncologic outcomes as conventional procedures, while being associated with such advantages as lower blood loss, fewer postoperative complications, and shorter hospital stay.

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Title: Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments
Authors: Le Xiao
Lun-jian Xiang
Jian-wei Li
Jian Chen
Yu-dong Fan
Shu-guo Zheng
Publication date: 01-10-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 10/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4214-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic versus open liver resection for hepatocellular carcinoma in posterosuperior segments

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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