Comparison of laparoscopic liver resection for hepatocellular carcinoma located in the posterosuperior segments or anterolateral segments: A case-matched analysis

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• 作者：Woohyung Lee ; MD ; Ho-Seong Han ; MD ; PhD ; ^{hanhs@snubh.org" class="auth_mail" title="E-mail the corresponding author} ; Yoo-Seok Yoon ; MD ; PhD ; Jai Young Cho ; MD ; PhD ; YoungRok Choi ; MD ; Hong Kyung Shin ; MD ; Jae Yool Jang ; MD ; Hanlim Choi ; MD ; Jae Seong Jang ; MD ; Seong Uk Kwon ; MD
• 刊名：Surgery
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：160
• 期：5
• 页码：1219-1226
• 全文大小：349 K

文摘

Laparoscopic liver resection is an attractive option for treating liver tumors. Laparoscopic liver resection is more difficult for hepatocellular carcinomas located in the posterosuperior segments than for hepatocellular carcinomas in the anterolateral segments. We compared perioperative and long-term outcomes between laparoscopic liver resection for hepatocellular carcinomas located in the posterosuperior and anterolateral segments.

Methods

We retrospectively reviewed the clinical data for 230 patients who underwent laparoscopic liver resection for hepatocellular carcinomas between September 2003 and July 2014. Of these, 116 patients were selected by case-matched analysis using age, sex, tumor number and size, Child-Pugh class, and extent of liver resection. Patients were classified into 2 groups according to tumor location: the anterolateral group (n = 58) and the posterosuperior group (n = 58).

Results

Operation time (355 minutes vs 212 minutes, P < .005), intraoperative blood loss (600 mL vs 410 mL, P < .001), and hospital stay (8.5 days vs 7 days, P = .040) were significantly greater in the posterosuperior group than in the anterolateral group. The open conversion (13.8% vs 10.3%, P = .777), postoperative complication (17.2% vs 10.3%, P = .420), 5-year overall survival (88.5% vs 85.7%, P = .370), and 5-year, recurrence-free survival (47.6% vs 40.9%, P = .678) rates were not significantly different between the posterosuperior and anterolateral groups.

Conclusion

Although laparoscopic liver resection is more difficult for hepatocellular carcinomas located in the posterosuperior segment, there were no differences in the short- and long-term outcomes between the posterosuperior and anterolateral groups. The perceived impact of tumor location on patient outcomes could be overcome by experience and technical improvements.