Ann Surg Treat Res.  2014 Feb;86(2):61-67. 10.4174/astr.2014.86.2.61.

The comparison of oncologic and clinical outcomes of laparoscopic liver resection for hepatocellular carcinoma

• Kim SJ
• Jung HK
• Lee DS
• Yun SS
• Kim HJ

• KMID: 1908499
• DOI: http://doi.org/10.4174/astr.2014.86.2.61

Abstract

PURPOSE
We evaluate the operative outcome and oncologic outcome of laparoscopic liver resection for hepatocellular carcinoma (HCC), and compare with open liver resection.
METHODS
From January 2004 to December 2012, clinical data of 70 patients who underwent laparoscopic liver resection for HCC (laparoscopic liver resection group, lapa-group) were collected and analyzed retrospectively. Control group (open liver resection group, open-group) were retrospectively matched, and compared with lapa-group.
RESULTS
Laparoscopic major liver resections were performed in 4 patients. Laparoscopic anatomical resections and nonanatomical resections were performed in 39 patients, and 31 patients, respectively. Mean operative time was shorter in lapa-group (215.5 +/- 121.84 minutes vs. 282.30 +/- 80.34 minutes, P = 0.001), mean intraoperative transfusion rate and total amount were small in lapa-group (24.28%, 148.57 +/- 3,354.98 mL vs. 40.78%, 311.71 +/- 477.01 mL). Open conversion occurred in 6 patients (8.57%) because of bleeding, inadequate resection, invisible mass on intraoperative ultrasonography, and tumor rupture. In lapa-group and open-group, 3-year disease-free survival rates were 58.3% +/- 0.08%, and 62.6% +/- 0.06%, respectively (P = 0.773). In lapa-group and open-group 3-year overall survival rates were 65.3% +/- 0.8%, and 65.7% +/- 0.6%, respectively (P = 0.610).
CONCLUSION
Laparoscopic liver resection for HCC is feasible and safe in a large number of patients, with reasonable operative and oncologic results.

Keyword

Laparoscopy; Hepatectomy; Hepatocellular carcinoma

MeSH Terms

Carcinoma, Hepatocellular*
Disease-Free Survival
Hemorrhage
Hepatectomy
Humans
Laparoscopy
Liver*
Operative Time
Retrospective Studies
Rupture
Survival Rate
Ultrasonography

Figure

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  Fig. 1 Receiver operating characteristic (ROC) curve. AUC, area under the curve.

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  Fig. 2 Overall survival rate.

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  Fig. 3 Disease-free survival rate.

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  Fig. 4 Right glissonian pedicle was clamped by laparoscopic intestinal clamp (A), then demarcation line is noted (B). Right glissonian pedicle is clamped by laparoscopic bulldog (C), then liver parenchyma is transected using an energy device (D).

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