The clinical application and evaluation of laparoscopic hepatectomy in the treatment of recurrent hepatocellular carcinoma

Abstract

Objective To explore the clinical safety and feasibility of completely laparoscopic hepatectomy for recurrent hepatocellular carcinoma. Methods The clinical data of 17 patients with recurrent hepatocellular carcinoma underwent completely laparoscopic hepatectomy from January 2015 to December 2017 were retrospectively analyzed. There were 13 males and 4 females with an age of 37-79 (51.3±7.6) years. The recurrence time was 3-39 (15.3±6.8) months. Hepatocellular carcinoma was clearly diagnosed in the past. The diameter of recurrent lesions was 1.3-3.5 (2.5±0.6) cm, including 12 patients with recurrent lesions on the opposite side, 3 patients on the same and 2 patients on both sides. Observe and record the following indicators of patients in detail, including the operative time, intraoperative hemorrhage, postoperative drainage volume, postoperative removal of drainage tube, the time of gastrointestinal recovery, total hospitalization time, postoperative complications and tumor recurrence. Results The completely laparoscopic hepatectomy of all patients with recurrent hepatocellular carcinoma were successfully performed. The operating time was 40-360 (130±40) min, the blood loss volume during operation was 50-800 (165±45) mL, and the drainage volume 40-360 (70±20) mL/d. The drainage tubes were removed 2-5 d after operation. The time of gastrointestinal recovery was 2-3 d after surgery, and the overall hospitalization was 3-14 (7.5±1.7) d. No serious postoperative complications occurred such as bile leakage, massive bleeding and air embolism. All cases were followed up for 6 to 24 months. One case in 3 months, two in 8 months and one in 14 months had tumor relapse, the others had no local recurrence and abdominal wall hole planting metastasis. There was no operative mortality. Conclusions Laparoscopic hepatectomy is a safe and feasible operation for recurrent hepatocellular carcinoma. It has the characteristics of small trauma and rapid recovery. This method has good results during short-term follow-up. But the selection of this surgical indications should be more careful and strict. Key words: Liver neoplasms; Laparoscopes; Hepatectomy; Neoplasm recurrence, local