DOI QR코드

DOI QR Code

Pure laparoscopic versus open left lateral sectionectomy for hepatocellular carcinoma: A propensity score matching analysis

  • Se-Jong Bae (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hwui-Dong Cho (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ki-Hun Kim (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin Hwang (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Chul-Soo Ahn (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Deok-Bog Moon (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Tae-Yong Ha (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Gi-Won Song (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Dong-Hwan Jung (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Gil-Chun Park (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Young-In Yoon (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Sung-Gyu Lee (Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2021.11.19
  • Accepted : 2021.11.22
  • Published : 2022.05.31

Abstract

Backgrounds/Aims: Anatomical resection has superior oncologic outcomes over non-anatomical resection in hepatocellular carcinoma, and left lateral sectionectomy is the simplest and easiest perform anatomical resection procedure among liver resections. The purpose of this study was to find out the safety and feasibility of pure laparoscopic left lateral sectionectomy (PLLLS) for hepatocellular carcinoma. Methods: Patients who underwent left lateral sectionectomy at a tertiary referral hospital, from August 2007 to April 2019 were enrolled in this retrospective study. After matching the 1 : 3 propensity score, 17 open and 51 pure laparoscopic cases were selected out of 102 cases of total left lateral resection for hepatocellular carcinoma. The group was analyzed in terms of patient demographics, preoperative data, and postoperative outcomes. Results: During the study period, there was no open conversion case. The mean operative time and complication were not statistically significant different between the two groups. There was no statistically significant difference in disease-free survival and overall survival had no statistical between the two groups. There were no mortality cases, and postoperative hospital stay was significantly shorter in the PLLLS group than in the open left lateral sectionectomy (OLLS) group. Conclusions: The oncologic outcomes and complication rate were the same in the PLLLS and OLLS groups. However, the hospital stay was shorter in the PLLLS group than in the OLLS group. The present study findings demonstrate that the PLLLS is a safe and feasible procedure for hepatocellular carcinoma.

Keywords

References

  1. Gagner M. Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 1992;6:97-98.
  2. Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg 2009;250:831-841.
  3. Cho HD, Kim KH, Hwang S, Ahn CS, Moon DB, Ha TY, et al. Comparison of pure laparoscopic versus open left hemihepatectomy by multivariate analysis: a retrospective cohort study. Surg Endosc 2018;32:643-650.
  4. Yoon YI, Kim KH, Kang SH, Kim WJ, Shin MH, Lee SK, et al. Pure laparoscopic versus open right hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a propensity score matched analysis. Ann Surg 2017;265:856-863.
  5. Cheung TT, Poon RT, Dai WC, Chok KS, Chan SC, Lo CM. Pure laparoscopic versus open left lateral sectionectomy for hepatocellular carcinoma: a single-center experience. World J Surg 2016;40:198-205.
  6. Yamamoto M, Takasaki K, Ohtsubo T, Katsuragawa H, Fukuda C, Katagiri S. Effectiveness of systematized hepatectomy with Glisson's pedicle transection at the hepatic hilus for small nodular hepatocellular carcinoma: retrospective analysis. Surgery 2001;130:443-448.
  7. Eguchi S, Kanematsu T, Arii S, Okazaki M, Okita K, Omata M, et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomical minor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery 2008;143:469-475.
  8. Jung DH, Hwang S, Lee YJ, Kim KH, Song GW, Ahn CS, et al. Small hepatocellular carcinoma with low tumor marker expression benefits more from anatomical resection than tumors with aggressive biology. Ann Surg 2019;269:511-519.
  9. Yang TH, Chen JL, Lin YJ, Chao YJ, Shan YS, Hsu HP, et al. Laparoscopic surgery for large left lateral liver tumors: safety and oncologic outcomes. Surg Endosc 2018;32:4314-4320.
  10. Macacari RL, Coelho FF, Bernardo WM, Kruger JAP, Jeismann VB, Fonseca GM, et al. Laparoscopic vs. open left lateral sectionectomy: an update meta-analysis of randomized and non-randomized controlled trials. Int J Surg 2019;61:1-10.
  11. Vigano L, Laurent A, Tayar C, Tomatis M, Ponti A, Cherqui D. The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 2009;250:772-782.
  12. Chua D, Syn N, Koh YX, Goh BKP. Learning curves in minimally invasive hepatectomy: systematic review and meta-regression analysis. Br J Surg 2021;108:351-358.
  13. Dokmak S, Raut V, Aussilhou B, Fteriche FS, Farges O, Sauvanet A, et al. Laparoscopic left lateral resection is the gold standard for benign liver lesions: a case-control study. HPB (Oxford) 2014;16:183-187.
  14. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 2015;261:619-629.