Takeshi Takahara1, Go Wakabayashi1, Toru Beppu2, Arihiro Aihara3, Kiyoshi Hasegawa4, Naoto Gotohda5, Etsuro Hatano6, Yoshinao Tanahashi7, Toru Mizuguchi8, Toshiya Kamiyama9, Tetsuo Ikeda10, Shogo Tanaka11, Nobuhiko Taniai12, Hideo Baba2, Minoru Tanabe3, Norihiro Kokudo4, Masaru Konishi5, Shinji Uemoto6, Atsushi Sugioka7, Koichi Hirata8, Akinobu Taketomi9, Yoshihiko Maehara10, Shoji Kubo11, Eiji Uchida12, Hiroaki Miyata13, Masafumi Nakamura14, Hironori Kaneko15, Hiroki Yamaue16, Masaru Miyazaki17, Tadahiro Takada18. 1. Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan. 2. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan. 3. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 4. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. 5. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. 6. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 7. Department of Surgery, Fujita Health University School of Medicine, Aichi, Japan. 8. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo, Japan. 9. Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan. 10. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 11. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. 12. Department of Gastrointestinal Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. 13. Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 14. Department of Digestive Surgery, Kawasaki Medical School, Okayama, Japan. 15. Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan. 16. Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan. 17. Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan. 18. Japanese Society of Hepato-biliary-Pancreatic Surgery, Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND: The aim of this study was to compare the long-term outcomes and perioperative outcomes of laparoscopic liver resection (LLR) with those of open liver resection (OLR) for hepatocellular carcinoma (HCC) between well-matched patient groups. METHODS: Hepatocellular carcinoma patients underwent primary liver resection between 2000 and 2010, were collected from 31 participating institutions in Japan and were divided into LLR (n = 436) and OLR (n = 2969) groups. A one-to-one propensity case-matched analysis was used with covariates of baseline characteristics, including tumor characteristics and surgical procedures of hepatic resections. Long-term and short-term outcomes were compared between the matched two groups. RESULTS: The two groups were well balanced by propensity score matching and 387 patients were matched. There were no significant differences in overall survival and disease-free survival between LLR and OLR. The median blood loss (158 g vs. 400 g, P < 0.001) was significantly less with LLR, and the median postoperative hospital stay (13 days vs. 16 days, P < 0.001) was significantly shorter for LLR. Complication rate (6.7% vs. 13.0%, P = 0.003) was significantly less in LLR. CONCLUSION: Compared with OLR, LLR in selected patients with HCC showed similar long-term outcomes, associated with less blood loss, shorter hospital stay, and fewer postoperative complications.
BACKGROUND: The aim of this study was to compare the long-term outcomes and perioperative outcomes of laparoscopic liver resection (LLR) with those of open liver resection (OLR) for hepatocellular carcinoma (HCC) between well-matched patient groups. METHODS:Hepatocellular carcinomapatients underwent primary liver resection between 2000 and 2010, were collected from 31 participating institutions in Japan and were divided into LLR (n = 436) and OLR (n = 2969) groups. A one-to-one propensity case-matched analysis was used with covariates of baseline characteristics, including tumor characteristics and surgical procedures of hepatic resections. Long-term and short-term outcomes were compared between the matched two groups. RESULTS: The two groups were well balanced by propensity score matching and 387 patients were matched. There were no significant differences in overall survival and disease-free survival between LLR and OLR. The median blood loss (158 g vs. 400 g, P < 0.001) was significantly less with LLR, and the median postoperative hospital stay (13 days vs. 16 days, P < 0.001) was significantly shorter for LLR. Complication rate (6.7% vs. 13.0%, P = 0.003) was significantly less in LLR. CONCLUSION: Compared with OLR, LLR in selected patients with HCC showed similar long-term outcomes, associated with less blood loss, shorter hospital stay, and fewer postoperative complications.
Authors: Nicolai A Schultz; Peter N Larsen; B Klarskov; L M Plum; Hans-Jørgen Frederiksen; Henrik Kehlet; Jens G Hillingsø Journal: World J Surg Date: 2018-06 Impact factor: 3.352
Authors: Brian K P Goh; Nicholas Syn; Jin-Yao Teo; Yu-Xin Guo; Ser-Yee Lee; Peng-Chung Cheow; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung; Chung-Yip Chan Journal: World J Surg Date: 2019-03 Impact factor: 3.352
Authors: Brian K P Goh; Darren Chua; Nicholas Syn; Jin-Yao Teo; Chung-Yip Chan; Ser-Yee Lee; Prema Raj Jeyaraj; Peng-Chung Cheow; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung Journal: World J Surg Date: 2018-12 Impact factor: 3.352