Brian K P Goh1,2, Nicholas Syn3, Jin-Yao Teo4, Yu-Xin Guo4, Ser-Yee Lee4, Peng-Chung Cheow4, Pierce K H Chow4, London L P J Ooi4, Alexander Y F Chung4, Chung-Yip Chan4. 1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore. bsgkp@hotmail.com. 2. Duke-NUS Medical School, Singapore, Singapore. bsgkp@hotmail.com. 3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 4. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
Abstract
BACKGROUND: This study aims to determine the safety and efficacy of laparoscopic repeat liver resection (LRLR) for recurrent hepatocellular carcinoma (rHCC). METHODS: Twenty patients underwent LRLR for rHCC between 2015 and 2017. The control groups consisted of 79 open RLR (ORLR) for rHCC and 185 LLR for primary HCC. We undertook propensity score-adjusted analyses (PSA) and 1:1 propensity score matching (PSM) for the comparison of LRLR versus ORLR. Comparison of LRLR versus LLR was done using multivariable regression models with adjustment for clinically relevant covariates. RESULTS: Twenty patients underwent LRLR with three open conversions (15%). Both PSA and 1:1-PSM demonstrated that LRLR was significantly associated with a shorter stay, superior disease-free survival (DFS) but longer operation time compared to ORLR. Comparison between LRLR versus LLR demonstrated that patients undergoing LRLR were significantly older, had smaller tumors, longer operation time and decreased frequency of Pringle's maneuver applied. There was no difference in other key perioperative outcomes. CONCLUSION: The results of this study demonstrate that in highly selected patients; LRLR for rHCC is feasible and safe. LRLR was associated with a shorter hospitalization but longer operation time compared to ORLR. Moreover, other than a longer operation time, LRLR was associated with similar perioperative outcomes compared to LLR for primary HCC.
BACKGROUND: This study aims to determine the safety and efficacy of laparoscopic repeat liver resection (LRLR) for recurrent hepatocellular carcinoma (rHCC). METHODS: Twenty patients underwent LRLR for rHCC between 2015 and 2017. The control groups consisted of 79 open RLR (ORLR) for rHCC and 185 LLR for primary HCC. We undertook propensity score-adjusted analyses (PSA) and 1:1 propensity score matching (PSM) for the comparison of LRLR versus ORLR. Comparison of LRLR versus LLR was done using multivariable regression models with adjustment for clinically relevant covariates. RESULTS: Twenty patients underwent LRLR with three open conversions (15%). Both PSA and 1:1-PSM demonstrated that LRLR was significantly associated with a shorter stay, superior disease-free survival (DFS) but longer operation time compared to ORLR. Comparison between LRLR versus LLR demonstrated that patients undergoing LRLR were significantly older, had smaller tumors, longer operation time and decreased frequency of Pringle's maneuver applied. There was no difference in other key perioperative outcomes. CONCLUSION: The results of this study demonstrate that in highly selected patients; LRLR for rHCC is feasible and safe. LRLR was associated with a shorter hospitalization but longer operation time compared to ORLR. Moreover, other than a longer operation time, LRLR was associated with similar perioperative outcomes compared to LLR for primary HCC.
Authors: Brian K P Goh; Pierce K H Chow; Jin-Yao Teo; Jen-San Wong; Chung-Yip Chan; Peng-Chung Cheow; Alexander Y F Chung; London L P J Ooi Journal: J Gastrointest Surg Date: 2014-05-23 Impact factor: 3.452
Authors: Albert C Y Chan; See Ching Chan; Kenneth S H Chok; Tan To Cheung; Dai Wing Chiu; Ronnie T P Poon; Sheung Tat Fan; Chung Mau Lo Journal: Liver Transpl Date: 2013-03-17 Impact factor: 5.799
Authors: Brian K P Goh; Chung-Yip Chan; Jen-San Wong; Ser-Yee Lee; Victor T W Lee; Peng-Chung Cheow; Pierce K H Chow; London L P J Ooi; Alexander Y F Chung Journal: Surg Endosc Date: 2014-11-27 Impact factor: 4.584
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Authors: Albert C Y Chan; Ronnie T P Poon; Kenneth S H Chok; Tan To Cheung; See Ching Chan; Chung Mau Lo Journal: World J Surg Date: 2014-05 Impact factor: 3.352
Authors: Yuxin Guo; Darren W Chua; Ye-Xin Koh; Ser-Yee Lee; Peng-Chung Cheow; Juinn-Huar Kam; Jin-Yao Teo; Pierce K Chow; Alexander Y Chung; London L Ooi; Chung-Yip Chan; Brian K P Goh Journal: World J Surg Date: 2019-10 Impact factor: 3.352
Authors: Darren W Chua; Nicholas Syn; Ye-Xin Koh; Jin-Yao Teo; Peng-Chung Cheow; Alexander Y F Chung; Chung-Yip Chan; Brian K P Goh Journal: Surg Endosc Date: 2022-08-23 Impact factor: 3.453
Authors: Yvette Chong; Ye-Xin Koh; Jin-Yao Teo; Peng-Chung Cheow; Pierce K Chow; Alexander Y Chung; Chung-Yip Chan; Brian K P Goh Journal: Surg Endosc Date: 2021-02-10 Impact factor: 4.584