Short- and Long-term Outcomes of Laparoscopic Versus Open Repeat Hepatectomy for Hepatocellular Carcinoma.

IF 1.7 4区医学 Q4 ONCOLOGY

Anticancer research Pub Date : 2025-08-01 DOI:10.21873/anticanres.17713

Shogo Fukutomi, Hisamune Sakai, Yuichi Goto, Kazuaki Hashimoto, Ryuta Midorikawa, Shoichiro Arai, Masanori Akashi, Taro Isobe, Takehumi Yoshida, Naoki Mori, Nobuya Ishibashi, Fumihiko Fujita, Toru Hisaka

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引用次数: 0

Abstract

Background/aim: Repeat hepatectomy for recurrent hepatocellular carcinoma (rHCC) can, sometimes, be difficult due to postoperative adhesions and altered liver anatomy. This study aimed to examine the advantages of laparoscopic repeat hepatectomy (LRH) compared to open repeat hepatectomy (ORH).

Patients and methods: One hundred and forty-six patients who underwent repeat hepatectomy for rHCC between April 2016 and December 2023 at Kurume University School of Medicine were enrolled. Of these, 105 patients underwent ORH, and 41 underwent LRH. The clinical characteristics and perioperative outcomes of the groups were compared using propensity score-matched (PSM) analysis.

Results: In the PSM analysis, there were 13 patients in each group (ORH-PSM group versus LRH-PSM group). There were no significant differences in clinical characteristics between the groups. Intraoperative blood loss (390 ml vs. 30 ml, p=0.004) was lower and the operation time (335 min vs. 208 min, p=0.009) and postoperative hospital stay (15 days vs. 8 days, p=0.0006) were shorter in the LRH-PSM group than in the ORH-PSM group. Although there was no significant difference in the frequency of postoperative complications with a Clavien-Dindo classification grade of IIIa or higher, such problems were only observed in the ORH-PSM group. There was no significant difference in the early recurrence rate (within 6 months) between the ORH-PSM and LRH-PSM groups. Similarly, no significant differences were observed in overall survival (OS) or recurrence-free survival (RFS) between the two groups.

Conclusion: LRH showed better short-term outcomes than ORH, while long-term outcomes were comparable.

查看原文本刊更多论文

腹腔镜与开放式重复肝切除术治疗肝细胞癌的短期和长期疗效。

背景/目的：由于术后粘连和肝脏解剖结构改变，复发性肝细胞癌（rHCC）的重复肝切除术有时是困难的。本研究旨在探讨腹腔镜重复肝切除术（LRH）与开放式重复肝切除术（ORH）的优势。患者和方法：纳入2016年4月至2023年12月在库鲁姆大学医学院接受rHCC重复肝切除术的146例患者。其中105例患者行ORH， 41例行LRH。采用倾向评分匹配（PSM）分析比较两组患者的临床特征和围手术期结局。结果：PSM分析中，ORH-PSM组和LRH-PSM组各有13例患者。两组间临床特征无显著差异。LRH-PSM组术中出血量（390 ml比30 ml， p=0.004）较低，手术时间（335 min比208 min， p=0.009）和术后住院时间（15天比8天，p=0.0006）较ORH-PSM组短。尽管Clavien-Dindo分级为IIIa或更高的两组术后并发症发生率无显著差异，但只有ORH-PSM组出现了此类问题。ORH-PSM组与LRH-PSM组早期复发率（6个月内）差异无统计学意义。同样，两组之间的总生存期（OS）或无复发生存期（RFS）也没有显著差异。结论：LRH近期疗效优于ORH，远期疗效与ORH相当。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anticancer research 医学-肿瘤学

CiteScore

3.70

自引率

10.00%

发文量

566

审稿时长

2 months

期刊介绍： ANTICANCER RESEARCH is an independent international peer-reviewed journal devoted to the rapid publication of high quality original articles and reviews on all aspects of experimental and clinical oncology. Prompt evaluation of all submitted articles in confidence and rapid publication within 1-2 months of acceptance are guaranteed. ANTICANCER RESEARCH was established in 1981 and is published monthly (bimonthly until the end of 2008). Each annual volume contains twelve issues and index. Each issue may be divided into three parts (A: Reviews, B: Experimental studies, and C: Clinical and Epidemiological studies). Special issues, presenting the proceedings of meetings or groups of papers on topics of significant progress, will also be included in each volume. There is no limitation to the number of pages per issue.