{"title":"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。","authors":"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","doi":"10.21873/anticanres.17713","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aim: </strong>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).</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>In the PSM analysis, there were 13 patients in each group (ORH-PSM group <i>versus</i> LRH-PSM group). There were no significant differences in clinical characteristics between the groups. Intraoperative blood loss (390 ml <i>vs.</i> 30 ml, <i>p</i>=0.004) was lower and the operation time (335 min <i>vs.</i> 208 min, <i>p</i>=0.009) and postoperative hospital stay (15 days <i>vs.</i> 8 days, <i>p</i>=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.</p><p><strong>Conclusion: </strong>LRH showed better short-term outcomes than ORH, while long-term outcomes were comparable.</p>","PeriodicalId":8072,"journal":{"name":"Anticancer research","volume":"45 8","pages":"3523-3530"},"PeriodicalIF":1.7000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Short- and Long-term Outcomes of Laparoscopic <i>Versus</i> Open Repeat Hepatectomy for Hepatocellular Carcinoma.\",\"authors\":\"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\",\"doi\":\"10.21873/anticanres.17713\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aim: </strong>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).</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>In the PSM analysis, there were 13 patients in each group (ORH-PSM group <i>versus</i> LRH-PSM group). There were no significant differences in clinical characteristics between the groups. Intraoperative blood loss (390 ml <i>vs.</i> 30 ml, <i>p</i>=0.004) was lower and the operation time (335 min <i>vs.</i> 208 min, <i>p</i>=0.009) and postoperative hospital stay (15 days <i>vs.</i> 8 days, <i>p</i>=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.</p><p><strong>Conclusion: </strong>LRH showed better short-term outcomes than ORH, while long-term outcomes were comparable.</p>\",\"PeriodicalId\":8072,\"journal\":{\"name\":\"Anticancer research\",\"volume\":\"45 8\",\"pages\":\"3523-3530\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anticancer research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21873/anticanres.17713\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anticancer research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21873/anticanres.17713","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
Short- and Long-term Outcomes of Laparoscopic Versus Open Repeat Hepatectomy for Hepatocellular Carcinoma.
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.
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.
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