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- Title
Efficacy and safety of laparoscopic hepatectomy for hepatocellular carcinoma comorbid with cirrhosis.
- Authors
Yoshihiro Inoue; Keisuke Yokohama; Hideko Ohama; Yusuke Tsuchimoto; Tetsuji Terazawa; Akira Asai; Shinya Fukunishi; Junji Okuda; Kazuhide Higuchi; Kazuhisa Uchiyama
- Abstract
Introduction: Laparoscopic hepatectomy (LH) is very difficult to perform in patients with cirrhosis because of the haemor-rhagic and fibrotic nature of the liver, although there are various advantages to laparoscopic surgery.Aim: To investigate the surgical outcomes, and efficacy and safety of LH versus open hepatectomy (OH) for hepatocellular carcinoma (HCC) resection.Material and methods:A total of 112 patients with cirrhosis, who underwent hepatectomy, were analysed retrospectively. We investigated the safety and efficacy of LH for HCC with cirrhosis. Student’s t and χ2 tests, Mann-Whitney’s U test, Wilcoxon’s signed-rank test, and Fisher’s exact test were used in the statistical analysis.Results:Seventy-one patients underwentLH, and 41 underwent OH. The conversion rate from LH to OH was 12.7%. After propensity score matching, the estimated blood loss was significantly lower in the LH group than in the OH group (25 vs. 310 ml; p < 0.001), and there was a significant difference between the groups in the operative time (p = 0.091). The LH group had complication rates of 3.6% and 0% for refractory ascites and pleural effusion, respectively, while those were 17.9% and 10.7%, respectively, in the OH group (p = 0.019 and p = 0.005, respectively). The LH group had no mortality, whereas the OH group had a mortality rate of 10.7% (p = 0.038). The postoperative length of stay was significantly longer in the LH group than in the OH group (9 days vs. 14 days) (p = 0.002).Conclusions: LH can be performed safely for HCC with cirrhosis. More favourable results are achieved with LH than with OH in terms of surgical outcomes.
- Subjects
MANN Whitney U Test; PARACENTESIS; HEPATOCELLULAR carcinoma; BLOOD loss estimation; COMORBIDITY; HEPATECTOMY
- Publication
Gastroenterology Review / Przegląd Gastroenterologiczny, 2020, Vol 15, Issue 3, p225
- ISSN
1895-5770
- Publication type
Article
- DOI
10.5114/pg.2020.99039