Fei Liu1, YongGang Wei2, Kefei Chen1, HongYu Li3, Wentao Wang1, Hong Wu1, Tianfu Wen1, Bo Li4. 1. Department of Liver Surgery&Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, 610041, Sichuan Province, China. 2. Department of Liver Surgery&Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, 610041, Sichuan Province, China. wyonggang688@163.com. 3. Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. 4. Department of Liver Surgery&Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, 610041, Sichuan Province, China. cdlibo688@163.com.
Abstract
BACKGROUND: Few studies have been performed to evaluate the value of the Glissonian approach (GA) for laparoscopic formal hemihepatectomy. The purpose of this study was to compare the outcomes of extrahepatic GA with those of the conventional hilar dissection approach for laparoscopic formal right and left hepatectomies in patients with hepatocellular carcinoma (HCC). METHODS: Between January 2015 and October 2017, a total of 95 HCC patients who underwent pure laparoscopic formal hemihepatectomies, of whom 49 underwent the GA, were included in this study. After a 1:1 propensity score matching, 42 laparoscopic GA hepatectomies were compared to 42 conventional approach (CA) hepatectomies. We have analyzed perioperative and oncologic outcomes of the two different operative approaches for HCC treatments. RESULTS: The GA did not increase the postoperative overall complication rates (P = 0.415) or the mean comprehensive complication index (P = 0.414) when compared with the CA. However, the operative time was significantly shorter (P = 0.006), and intraoperative blood loss was significantly lower (P < 0.001) in the GA group than in the CA group. There were no significant differences between the GA and CA groups regarding 3-year overall survival rate (P = 0.765) or 3-year disease-free survival rate (P = 0.622). CONCLUSIONS: Pure laparoscopic extrahepatic GA hemihepatectomy is safe and feasible, and it was associated with similar complication rates and equivalent 3-year survival outcomes compared to the conventional approach in selected patients with HCC.
BACKGROUND: Few studies have been performed to evaluate the value of the Glissonian approach (GA) for laparoscopic formal hemihepatectomy. The purpose of this study was to compare the outcomes of extrahepatic GA with those of the conventional hilar dissection approach for laparoscopic formal right and left hepatectomies in patients with hepatocellular carcinoma (HCC). METHODS: Between January 2015 and October 2017, a total of 95 HCC patients who underwent pure laparoscopic formal hemihepatectomies, of whom 49 underwent the GA, were included in this study. After a 1:1 propensity score matching, 42 laparoscopic GA hepatectomies were compared to 42 conventional approach (CA) hepatectomies. We have analyzed perioperative and oncologic outcomes of the two different operative approaches for HCC treatments. RESULTS: The GA did not increase the postoperative overall complication rates (P = 0.415) or the mean comprehensive complication index (P = 0.414) when compared with the CA. However, the operative time was significantly shorter (P = 0.006), and intraoperative blood loss was significantly lower (P < 0.001) in the GA group than in the CA group. There were no significant differences between the GA and CA groups regarding 3-year overall survival rate (P = 0.765) or 3-year disease-free survival rate (P = 0.622). CONCLUSIONS: Pure laparoscopic extrahepatic GA hemihepatectomy is safe and feasible, and it was associated with similar complication rates and equivalent 3-year survival outcomes compared to the conventional approach in selected patients with HCC.
Authors: Dimitrios Tzanis; Nairuthya Shivathirthan; Alexis Laurent; Mohammad Abu Hilal; Olivier Soubrane; Airazat M Kazaryan; Giuseppe Maria Ettore; Ronald M Van Dam; Panagiotis Lainas; Hadrien Tranchart; Bjorn Edwin; Giulio Belli; Ricardo Robles Campos; Neil Pearce; Brice Gayet; Ibrahim Dagher Journal: J Hepatobiliary Pancreat Sci Date: 2013-02 Impact factor: 7.027
Authors: Marcel Autran C Machado; Rodrigo C Surjan; Tiago Basseres; Erik Schadde; Frederico P Costa; Fábio F Makdissi Journal: Surgery Date: 2016-03-03 Impact factor: 3.982
Authors: Nuh N Rahbari; O James Garden; Robert Padbury; Guy Maddern; Moritz Koch; Thomas J Hugh; Sheung Tat Fan; Yuji Nimura; Joan Figueras; Jean-Nicolas Vauthey; Myrddin Rees; Rene Adam; Ronald P Dematteo; Paul Greig; Val Usatoff; Simon Banting; Masato Nagino; Lorenzo Capussotti; Yukihiro Yokoyama; Mark Brooke-Smith; Michael Crawford; Christopher Christophi; Masatoshi Makuuchi; Markus W Büchler; Jürgen Weitz Journal: HPB (Oxford) Date: 2011-06-07 Impact factor: 3.647
Authors: Moritz Koch; O James Garden; Robert Padbury; Nuh N Rahbari; Rene Adam; Lorenzo Capussotti; Sheung Tat Fan; Yukihiro Yokoyama; Michael Crawford; Masatoshi Makuuchi; Christopher Christophi; Simon Banting; Mark Brooke-Smith; Val Usatoff; Masato Nagino; Guy Maddern; Thomas J Hugh; Jean-Nicolas Vauthey; Paul Greig; Myrddin Rees; Yuji Nimura; Joan Figueras; Ronald P DeMatteo; Markus W Büchler; Jürgen Weitz Journal: Surgery Date: 2011-02-12 Impact factor: 3.982