Ann Surg Treat Res.  2024 Jun;106(6):354-360. 10.4174/astr.2024.106.6.354.

Long-term outcomes of single-port laparoscopic hepatectomy for hepatocellular carcinoma: a retrospective comparative analysis

• Seo CH
• Choi HJ
• You YK

• KMID: 2556327
• DOI: http://doi.org/10.4174/astr.2024.106.6.354

Abstract

Purpose
Numerous efforts have been made to achieve minimally invasive surgery, such as single-port laparoscopic surgery. However, few studies have provided long-term follow-up information, and the number of patients with hepatocellular carcinoma (HCC) in previous studies has been small. The purpose in this study is to compare the long-term oncological outcomes of HCC patients who underwent single-port laparoscopic hepatectomy (SPLH) with those of patients who underwent multiport laparoscopic hepatectomy (MPLH).
Methods
We retrospectively reviewed the medical records of 135 patients with HCC who underwent laparoscopic liver between January 2008 and December 2018. Of the 135 patients, 53 underwent MPLH, and 82 underwent SPLH.
Results
From January 2008 to December 2018, 135 patients underwent laparoscopic hepatectomy for HCC. Among them, 82 patients underwent SPLH, and 53 patients underwent MPLH. Neither long-term overall survival (P = 0.849) nor recurrence-free survival (P = 0.057) differed significantly between the 2 groups, even though the recurrence rate was higher in the SPLH group. In the univariable analysis of risk factors for recurrence, multiple tumors, SPLH method, and portal vein invasion were statistically significant (P < 0.05). Multivariable analysis showed that the SPLH method and portal vein invasion were independent adverse prognostic factors for recurrence-free survival.
Conclusion
In terms of both short-term and long-term outcomes, the SPLH method seems to be a feasible approach for HCC in select patients. Because the potential risk of margin recurrence might produce poor oncological outcomes, strict patient selection is essential to ensure that an adequate safety margin can be secured.

Keyword

Hepatocellular carcinoma; Minimally invasive surgery; Recurrence

Figure

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  Fig. 1 Recurrence-free-survival (RFS). MPLH, multiport laparoscopic hepatectomy; SPLH, single-port laparoscopic hepatectomy.

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  Fig. 2 Overall survival (OS). MPLH, multiport laparoscopic hepatectomy; SPLH, single-port laparoscopic hepatectomy.

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