File Download
There are no files associated with this item.
Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1016/j.suronc.2020.09.012
- Scopus: eid_2-s2.0-85091223605
- PMID: 32977103
- WOS: WOS:000600067100004
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Pure laparoscopic versus open major hepatectomy for hepatocellular carcinoma with liver F4 cirrhosis without routine Pringle maneuver – A propensity analysis in a single center
Title | Pure laparoscopic versus open major hepatectomy for hepatocellular carcinoma with liver F4 cirrhosis without routine Pringle maneuver – A propensity analysis in a single center |
---|---|
Authors | |
Keywords | Laparoscopic liver resection Survival analysis Technique Liver cancer Complex liver surgery HCC Cirrhosis |
Issue Date | 2020 |
Citation | Surgical Oncology, 2020, v. 35, p. 315-320 How to Cite? |
Abstract | © 2020 Elsevier Ltd Background: /Aim: Laparoscopic hepatectomy has been gaining popularity but its evidence in major hepatectomy for cirrhotic liver is lacking. We studied the long-term outcomes of the pure laparoscopic approach versus the open approach in major hepatectomy without Pringle maneuver in patients with hepatocellular carcinoma (HCC) and cirrhosis using the propensity score analysis. Methods: We reviewed patients diagnosed with HCC and cirrhosis who underwent major hepatectomy as primary treatment. The outcomes of patients who received the laparoscopic approach were compared with those of propensity-case-matched patients (ratio, 4:1) who received the open approach. The matching was made on the following factors: tumor size, tumor number, age, sex, hepatitis serology, HCC staging, comorbidity, and liver function. Results: Twenty-four patients underwent pure laparoscopic major hepatectomy for HCC with cirrhosis. Ninety-six patients who underwent open major hepatectomy were matched by propensity scores. The laparoscopic group had less median blood loss (300 ml vs 645 ml, p = 0.001), shorter median hospital stay (6 days vs 10 days, p = 0.002), and lower rates of overall complication (12.5% vs 39.6%, p = 0.012), pulmonary complication (4.2% vs 25%, p = 0.049) and pleural effusion (p = 0.026). The 1-year, 3-year and 5-year overall survival rates in the laparoscopic group vs the open group were 95.2%, 89.6% and 89.6% vs 87.5%, 72.0% and 62.8% (p = 0.211). Correspondingly, the disease-free survival rates were 77.1%, 71.2% and 71.2% vs 75.8%, 52.7% and 45.5% (p = 0.422). Conclusions: The two groups had similar long-term survival. The laparoscopic group had favorable short-term outcomes. Laparoscopic major hepatectomy without routine Pringle maneuver for HCC with cirrhosis is a safe treatment option at specialized centers. |
Persistent Identifier | http://hdl.handle.net/10722/295181 |
ISSN | 2021 Impact Factor: 2.388 2020 SCImago Journal Rankings: 0.989 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Ma, KW | - |
dc.contributor.author | She, WH | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Tsang, SHY | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Lo, CM | - |
dc.date.accessioned | 2021-01-05T04:59:14Z | - |
dc.date.available | 2021-01-05T04:59:14Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Surgical Oncology, 2020, v. 35, p. 315-320 | - |
dc.identifier.issn | 0960-7404 | - |
dc.identifier.uri | http://hdl.handle.net/10722/295181 | - |
dc.description.abstract | © 2020 Elsevier Ltd Background: /Aim: Laparoscopic hepatectomy has been gaining popularity but its evidence in major hepatectomy for cirrhotic liver is lacking. We studied the long-term outcomes of the pure laparoscopic approach versus the open approach in major hepatectomy without Pringle maneuver in patients with hepatocellular carcinoma (HCC) and cirrhosis using the propensity score analysis. Methods: We reviewed patients diagnosed with HCC and cirrhosis who underwent major hepatectomy as primary treatment. The outcomes of patients who received the laparoscopic approach were compared with those of propensity-case-matched patients (ratio, 4:1) who received the open approach. The matching was made on the following factors: tumor size, tumor number, age, sex, hepatitis serology, HCC staging, comorbidity, and liver function. Results: Twenty-four patients underwent pure laparoscopic major hepatectomy for HCC with cirrhosis. Ninety-six patients who underwent open major hepatectomy were matched by propensity scores. The laparoscopic group had less median blood loss (300 ml vs 645 ml, p = 0.001), shorter median hospital stay (6 days vs 10 days, p = 0.002), and lower rates of overall complication (12.5% vs 39.6%, p = 0.012), pulmonary complication (4.2% vs 25%, p = 0.049) and pleural effusion (p = 0.026). The 1-year, 3-year and 5-year overall survival rates in the laparoscopic group vs the open group were 95.2%, 89.6% and 89.6% vs 87.5%, 72.0% and 62.8% (p = 0.211). Correspondingly, the disease-free survival rates were 77.1%, 71.2% and 71.2% vs 75.8%, 52.7% and 45.5% (p = 0.422). Conclusions: The two groups had similar long-term survival. The laparoscopic group had favorable short-term outcomes. Laparoscopic major hepatectomy without routine Pringle maneuver for HCC with cirrhosis is a safe treatment option at specialized centers. | - |
dc.language | eng | - |
dc.relation.ispartof | Surgical Oncology | - |
dc.subject | Laparoscopic liver resection | - |
dc.subject | Survival analysis | - |
dc.subject | Technique | - |
dc.subject | Liver cancer | - |
dc.subject | Complex liver surgery | - |
dc.subject | HCC | - |
dc.subject | Cirrhosis | - |
dc.title | Pure laparoscopic versus open major hepatectomy for hepatocellular carcinoma with liver F4 cirrhosis without routine Pringle maneuver – A propensity analysis in a single center | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.suronc.2020.09.012 | - |
dc.identifier.pmid | 32977103 | - |
dc.identifier.scopus | eid_2-s2.0-85091223605 | - |
dc.identifier.volume | 35 | - |
dc.identifier.spage | 315 | - |
dc.identifier.epage | 320 | - |
dc.identifier.eissn | 1879-3320 | - |
dc.identifier.isi | WOS:000600067100004 | - |
dc.identifier.issnl | 0960-7404 | - |