Hepatectomy Based on the Tumor Hemodynamics for Hepatocellular Carcinoma: a Comparison Among the Hybrid and Pure Laparoscopic Procedures and Open Surgery

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2012 Sep 1

PMID 22936439

Citations 15

Authors

Shogo Kobayashi

Hiroaki Nagano

Shigeru Marubashi

Koichi Kawamoto

Hiroshi Wada

Hidetoshi Eguchi

Masahiro Tanemura

Koji Umeshita

Yuichiro Doki

Masaki Mori

Affiliations

Soon will be listed here.

Abstract

Purpose: This study was designed to evaluate the surgical parameters and treatment outcomes of tumor hemodynamics-based pure laparoscopic (PURE) and laparoscopy-assisted (HYBRID) hepatectomy for small hepatocellular carcinoma (HCC) compared with those of open hepatectomy.

Methods: Using a prospectively collected database from 1997 to 2011, we analyzed the data of 56 consecutive cases of laparoscopic hepatectomy for HCC (PURE, n = 24; HYBRID, n = 29; HALS, n = 3) from among 102 cases undergoing laparoscopic hepatectomy. We employed 27 cases treated by open hepatectomy during the same period as controls.

Results: PURE was associated with lesser blood loss, lower weight of the resected liver, and a shorter skin incision than HYBRID and open hepatectomy [median blood loss (mL): PURE 7, HYBRID 380, Open 450; P < 0.05]. On the other hand, HYBRID hepatectomy was associated with a longer operation time [operation time (min): HYBRID 232, Open 185; P = 0.0226]. The length of hospitalization in the cases treated by PURE and HYBRID hepatectomy was shorter than that in the cases treated by open hepatectomy [length of hospitalization (days): PURE 11, HYBRID 12, Open 17; P < 0.05]. One case each of transfusion and morbidity was recorded in this series. There was no significant difference of the overall (OS) or disease-free survival (DFS) between the patients treated by laparoscopic and open hepatectomy (3-year OS: 100 vs. 100 %; DFS 50 vs. 62 %, respectively).

Conclusions: Neither the surgical parameters nor the treatment outcomes of hemodynamics-based laparoscopic hepatectomy were inferior to those of open hepatectomy.

Citing Articles

Long-term survival outcome of laparoscopic liver resection for hepatocellular carcinoma.

Lam S, Cheng K World J Gastrointest Surg. 2021; 13(10):1110-1121.

PMID: 34754381 PMC: 8554717. DOI: 10.4240/wjgs.v13.i10.1110.

Open versus laparoscopic hepatic resection for hepatocellular carcinoma: a systematic review and meta-analysis.

Xiangfei M, Yinzhe X, Yingwei P, ShiChun L, Weidong D Surg Endosc. 2019; 33(8):2396-2418.

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Current topics in liver surgery.

Yamazaki S, Takayama T Ann Gastroenterol Surg. 2019; 3(2):146-159.

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Meta-analysis of short- and long-term outcomes after pure laparoscopic versus open liver surgery in hepatocellular carcinoma patients.

Witowski J, Rubinkiewicz M, Mizera M, Wysocki M, Gajewska N, Sitkowski M Surg Endosc. 2018; 33(5):1491-1507.

PMID: 30203210 PMC: 6484823. DOI: 10.1007/s00464-018-6431-6.

Short-term outcomes of open liver resection and laparoscopic liver resection: Secondary analysis of data from a multicenter prospective study (CSGO-HBP-004).

Kobayashi S, Fukui K, Takeda Y, Nakahira S, Tsujie M, Shimizu J Ann Gastroenterol Surg. 2018; 2(1):87-94.

PMID: 29863161 PMC: 5881366. DOI: 10.1002/ags3.12046.

References

Kaneko H, Takagi S, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T . Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005; 189(2):190-4. DOI: 10.1016/j.amjsurg.2004.09.010. View

Sakon M, Nagano H, Nakamori S, Dono K, Umeshita K, Murakami T . Intrahepatic recurrences of hepatocellular carcinoma after hepatectomy: analysis based on tumor hemodynamics. Arch Surg. 2002; 137(1):94-9. DOI: 10.1001/archsurg.137.1.94. View

Shimada M, Hashizume M, Maehara S, Tsujita E, Rikimaru T, Yamashita Y . Laparoscopic hepatectomy for hepatocellular carcinoma. Surg Endosc. 2001; 15(6):541-4. DOI: 10.1007/s004640080099. View

Tranchart H, Di Giuro G, Lainas P, Roudie J, Agostini H, Franco D . Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg Endosc. 2009; 24(5):1170-6. DOI: 10.1007/s00464-009-0745-3. View

Sasaki A, Kai S, Iwashita Y, Hirano S, Ohta M, Kitano S . Microsatellite distribution and indication for locoregional therapy in small hepatocellular carcinoma. Cancer. 2004; 103(2):299-306. DOI: 10.1002/cncr.20798. View

Ueda K, Matsui O, Kawamori Y, Nakanuma Y, Kadoya M, Yoshikawa J . Hypervascular hepatocellular carcinoma: evaluation of hemodynamics with dynamic CT during hepatic arteriography. Radiology. 1998; 206(1):161-6. DOI: 10.1148/radiology.206.1.9423667. View

Tang Z, Yu Y, Zhou X, Ma Z, Yang R, Lu J . Surgery of small hepatocellular carcinoma. Analysis of 144 cases. Cancer. 1989; 64(2):536-41. DOI: 10.1002/1097-0142(19890715)64:2<536::aid-cncr2820640230>3.0.co;2-x. View

Morimoto O, Nagano H, Miyamoto A, Fujiwara Y, Kondo M, Yamamoto T . Association between recurrence of hepatocellular carcinoma and alpha-fetoprotein messenger RNA levels in peripheral blood. Surg Today. 2005; 35(12):1033-41. DOI: 10.1007/s00595-005-3077-5. View

Marubashi S, Nagano H, Wada H, Kobayashi S, Eguchi H, Takeda Y . Clinical significance of alpha-fetoprotein mRNA in peripheral blood in liver resection for hepatocellular carcinoma. Ann Surg Oncol. 2011; 18(8):2200-9. DOI: 10.1245/s10434-011-1577-7. View

10.

Li N, Wu Y, Wu B, Lu M . Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis. Hepatol Res. 2011; 42(1):51-9. DOI: 10.1111/j.1872-034X.2011.00890.x. View

11.

Tomimaru Y, Eguchi H, Marubashi S, Wada H, Kobayashi S, Tanemura M . Equivalent outcomes after anatomical and non-anatomical resection of small hepatocellular carcinoma in patients with preserved liver function. Dig Dis Sci. 2012; 57(7):1942-8. DOI: 10.1007/s10620-012-2114-7. View

12.

Hasegawa K, Kokudo N, Imamura H, Matsuyama Y, Aoki T, Minagawa M . Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg. 2005; 242(2):252-9. PMC: 1357731. DOI: 10.1097/01.sla.0000171307.37401.db. View

13.

Kanematsu T, Takenaka K, Matsumata T, Furuta T, Sugimachi K, Inokuchi K . Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg. 1984; 199(1):51-6. PMC: 1353257. DOI: 10.1097/00000658-198401000-00009. View

14.

Cho A, Asano T, Yamamoto H, Nagata M, Takiguchi N, Kainuma O . Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection. Surg Endosc. 2007; 21(8):1466-8. DOI: 10.1007/s00464-007-9253-5. View

15.

Zhou Y, Shao W, Zhao Y, Xu D, Li B . Meta-analysis of laparoscopic versus open resection for hepatocellular carcinoma. Dig Dis Sci. 2011; 56(7):1937-43. DOI: 10.1007/s10620-011-1572-7. View

16.

Kim H, Park E, Seoung J, Hur Y, Koh Y, Kim J . Liver resection for hepatocellular carcinoma: case-matched analysis of laparoscopic versus open resection. J Korean Surg Soc. 2011; 80(6):412-9. PMC: 3204693. DOI: 10.4174/jkss.2011.80.6.412. View

17.

Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez P . Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg. 2003; 138(7):763-9; discussion 769. DOI: 10.1001/archsurg.138.7.763. View

18.

Aldrighetti L, Guzzetti E, Pulitano C, Cipriani F, Catena M, Paganelli M . Case-matched analysis of totally laparoscopic versus open liver resection for HCC: short and middle term results. J Surg Oncol. 2010; 102(1):82-6. DOI: 10.1002/jso.21541. View

19.

Kosuge T, Makuuchi M, Takayama T, Yamamoto J, Shimada K, Yamasaki S . Long-term results after resection of hepatocellular carcinoma: experience of 480 cases. Hepatogastroenterology. 1993; 40(4):328-32. View

20.

Koffron A, Auffenberg G, Kung R, Abecassis M . Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg. 2007; 246(3):385-92. PMC: 1959347. DOI: 10.1097/SLA.0b013e318146996c. View