Long-term and short-term surgical outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma: might laparoscopic approach be better in early HCC?

2018 ◽  
Vol 33 (4) ◽  
pp. 1131-1139 ◽  
Author(s):  
Kuei-Yen Tsai ◽  
Hsin-An Chen ◽  
Wan-Yu Wang ◽  
Ming-Te Huang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Surgical Outcomes ◽  
Laparoscopic Approach ◽  
Short Term ◽  
Open Liver Resection ◽  
Early Hcc

Assessment of Safety and Applicability of Laparoscopic vs Open Non Anatomical Resection of Hepatocellular Carcinoma in Cirrhotic Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Mahfouz Mohammed ◽  
Hany Saeed Abdel Basset ◽  
Mohammed Abd Almegeed Elsayed ◽  
Ahmed Abdel Basset Hegazi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Laparoscopic Liver Resection ◽  
Operative Time ◽  
Short Term ◽  
Open Liver Resection ◽  
Resection Group ◽  
Significant Difference ◽  
Cirrhotic Patients ◽  
The Mean

Abstract Background Laparoscopic liver resection (LLR) has been progressively developed along the past two decades. Liver surgery was one of the last frontiers reached by minimally invasive surgery. Surgical technique and equipment evolved to overcome technical limitations, making laparoscopic liver resections (LLR) safe and feasible. Surgeons developed skills in a stepwise approach, beginning with low complexity operations for benign diseases and reaching high-complexity surgeries for malignant cases and living donor organ harvesting. Objective s: The aim of the study is to compare short term results of laparoscopic versus open hepatectomy regarding to intra operative details and post-operative management and complications for achieving a safe hepatic resection for treatment of HCC in cirrhotic patients. Patients and Methods In this prospective study, a comparison between laparoscopic resection and open resection was done to compare short-term results between laparoscopic and open liver resection. This study was conducted on 30 patients with hepatocellular carcinoma. 15 patients (50%) were treated by laparoscopic liver resection (Group A) while the other 15 patients (50%) were treated by open liver resection (Group B). Results Regarding the demographic data, the presence of past history of medical condition and the preoperative laboratory results, no statistical significance was found. The mean operative time has statistically significant difference between the 2 groups, with decreased operative time in the laparoscopic group (P < 0.001). The mean blood loss has no statistically significant difference relations between the 2 groups, (P = 0.866) with conversion rate of (13.3%) happened in two cases. Conclusion Laparoscopic liver resection is a safe and feasible treatment option for HCC in cirrhotic patient needing minor resection at laparoscopic segments (II, III, IVa,V,VI). Laparoscopic liver resection for HCC has superior short- term and comparable oncological outcomes to open liver resection. LLR should be performed for carefully selected patients and by an expert surgical team.

scholarly journals Elderly Hepatocellular Carcinoma Patients: Open or Laparoscopic Approach?

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2281
Author(s):  
Jong Man Kim ◽  
Sangjin Kim ◽  
Jinsoo Rhu ◽  
Gyu-Seong Choi ◽  
Choon Hyuck David Kwon ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Elderly Patients ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Laparoscopic Approach ◽  
Operation Time ◽  
Transfusion Rate ◽  
Treatment Naïve

It remains unclear whether the short-term benefits and long-term outcomes of laparoscopic liver resection (LLR) accrue to elderly patients with medical comorbidities. The aim of the present study was to compare the outcomes between LLR and open liver resection (OLR) in elderly patients (≥65 years) with solitary, treatment-naïve solitary hepatocellular carcinoma (HCC). From January 2013 to August 2017, 256 elderly patients with solitary treatment-naive HCC underwent liver resection. All patients were Child–Pugh class A and older than 65 years. The OLR and LLR groups contained 160 and 96 patients, respectively. The median tumor size in the OLR group was significantly larger than that in the LLR group (3.9 vs. 2.6 cm), but the tumor size did not differ between the two groups after matching. The median operation time, blood loss, transfusion rate, and postoperative complications in the OLR group did not differ from those in the LLR group, but the operation time in the LLR group was longer than that in the OLR group after matching. The median hospitalization in the LLR group was significantly shorter than that in the OLR group. Disease-free survival (DFS) in the LLR group was better than that in the OLR group before and after matching, but the difference was not significant. Patient survival (PS) in the LLR group was similar to that in the OLR group. LLR is feasible and safe for elderly patients with solitary, treatment-naïve HCC. The short- and long-term benefits of LLR are evident in geriatric oncological liver surgery patients.

scholarly journals Short-term outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma in elderly patients: A propensity score matching analysis

2020 ◽  
Author(s):  
Kazuteru Monden ◽  
Hiroshi Sadamori ◽  
Masayoshi Hioki ◽  
Satoshi Ohno ◽  
Norihisa Takakura
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Propensity Score ◽  
Elderly Patients ◽  
Propensity Score Matching ◽  
Oral Intake ◽  
Short Term ◽  
Open Liver Resection ◽  
Propensity Score Matching Analysis ◽  
Baseline Characteristics

Abstract The number of elderly patients with hepatocellular carcinoma (HCC) requiring surgical treatment has been continuously increasing. This study aimed to examine the safety and feasibility of laparoscopic liver resection (LLR) versus open liver resection (OLR) for HCC in elderly patients at our institution in Japan.Between 2010 and 2018, LLR and OLR were performed in 80 and 138 elderly patients (>70 years) who were diagnosed with HCC, respectively. Propensity score matching (PSM) analysis with covariates of baseline characteristics was applied. Intra- and postoperative data were evaluated in both groups.After PSM, 56 patients who underwent LLR and OLR, respectively, were compared. No significant differences in demographic, clinical data, and operative times were observed. Blood loss (OLR: 327 mL; LLR: 50 mL; P< 0.001), length of postoperative hospital stay (OLR: 12 days; LLR: 7 days; P< 0.001), and time to start oral intake (OLR: 2 days; LLR: 1 day; P< 0.001) were significantly lower and shorter in the LLR group than in the OLR group. The incidence of complications over Clavien-Dindo class IIIa was similar between both groups.Our results suggest that advanced age alone is not a contraindication, and LLR can be a treatment option for elderly patients with HCC.

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