Hepatectomy based on the tumor hemodynamics for hepatocellular carcinoma: a comparison among the hybrid and pure laparoscopic procedures and open surgery

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• 作者：Shogo Kobayashi (1)
  Hiroaki Nagano (1)
  Shigeru Marubashi (1)
  Koichi Kawamoto (1)
  Hiroshi Wada (1)
  Hidetoshi Eguchi (1)
  Masahiro Tanemura (1)
  Koji Umeshita (1)
  Yuichiro Doki (1)
  Masaki Mori (1)
  
• 关键词：Hepatocellular carcinoma ; Laparoscopic hepatectomy ; Tumor hemodynamics
• 刊名：Surgical Endoscopy
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：27
• 期：2
• 页码：610-617
• 全文大小：316KB
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• 作者单位：Shogo Kobayashi (1)
  Hiroaki Nagano (1)
  Shigeru Marubashi (1)
  Koichi Kawamoto (1)
  Hiroshi Wada (1)
  Hidetoshi Eguchi (1)
  Masahiro Tanemura (1)
  Koji Umeshita (1)
  Yuichiro Doki (1)
  Masaki Mori (1)
  
  1. Department of Surgery, Osaka University, Yamadaoka 2-2(E2), Suita, Osaka, 565-0871, Japan
  
• ISSN：1432-2218

文摘

Purpose This study was designed to evaluate the surgical parameters and treatment outcomes of tumor hemodynamics-based pure laparoscopic (PURE) and laparoscopy-assisted (HYBRID) hepatectomy for small hepatocellular carcinoma (HCC) compared with those of open hepatectomy. Methods Using a prospectively collected database from 1997 to 2011, we analyzed the data of 56 consecutive cases of laparoscopic hepatectomy for HCC (PURE, n?=?24; HYBRID, n?=?29; HALS, n?=?3) from among 102 cases undergoing laparoscopic hepatectomy. We employed 27 cases treated by open hepatectomy during the same period as controls. Results PURE was associated with lesser blood loss, lower weight of the resected liver, and a shorter skin incision than HYBRID and open hepatectomy [median blood loss (mL): PURE 7, HYBRID 380, Open 450; P?<?0.05]. On the other hand, HYBRID hepatectomy was associated with a longer operation time [operation time (min): HYBRID 232, Open 185; P?=?0.0226]. The length of hospitalization in the cases treated by PURE and HYBRID hepatectomy was shorter than that in the cases treated by open hepatectomy [length of hospitalization (days): PURE 11, HYBRID 12, Open 17; P?<?0.05]. One case each of transfusion and morbidity was recorded in this series. There was no significant difference of the overall (OS) or disease-free survival (DFS) between the patients treated by laparoscopic and open hepatectomy (3-year OS: 100 vs. 100?%; DFS 50 vs. 62?%, respectively). Conclusions Neither the surgical parameters nor the treatment outcomes of hemodynamics-based laparoscopic hepatectomy were inferior to those of open hepatectomy.