Abstract
BackgroundLaparoscopic liver resection has been reported as a safe and effective approach for the management of hepatocellular carcinoma (HCC). However, its perioperative and oncological outcomes have not been evaluated in left hepatectomy patients. The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC.MethodsFrom December 2012 to October 2016, laparoscopic left hepatectomy (LLH) was performed in 40 patients and open left hepatectomy (OLH) was performed in 80 patients. All clinical data were analyzed retrospectively. Propensity score matching of patients in a 1:1 ratio was conducted based on tumor size and presence of microvascular invasion.ResultsTumor size and presence of microvascular invasion were higher in the OLH group than the LLH group (P < 0.05). However, the operative time was longer in the LLH group than in the OLH group (266 min vs. 239 min; P = 0.005). The median postoperative hospital stay was significantly shorter in the LLH group than in the OLH group before and after matching (9 days vs. 13 days; P < 0.001). The incidence of complications in the LLH and OLH groups was 10.0 and 7.5%, respectively. The disease-free survival (DFS) and overall survival (OS) in the LLH group were not different from those in the OLH group after propensity score matching.ConclusionsA laparoscopic approach is feasible and safe for left HCC. The oncologic outcome of LLH is comparable to that of OLH.
Highlights
Laparoscopic liver resection has been reported as a safe and effective approach for the management of hepatocellular carcinoma (HCC)
The median postoperative hospital stay was significantly shorter in the laparoscopic left hepatectomy (LLH) group than in the open left hepatectomy (OLH) group before and after matching (9 days vs. 13 days; P < 0.001)
We focused on only left hepatectomy in patients with solitary HCC because surgical approaches are different depending on tumor location
Summary
Laparoscopic liver resection has been reported as a safe and effective approach for the management of hepatocellular carcinoma (HCC). The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC. Laparoscopic major liver resections have been limited to a few institutions due to the technical demands of the procedure [7, 10,11,12]. Kim et al BMC Cancer (2018) 18:668 the outcomes of purely laparoscopic right hepatectomy in HCC patients were comparable to those of open right hepatectomy [7], left major hepatectomy has been limited to a few medical centers because of its technical complexity [11]. No report has described the feasibility of pure laparoscopic left hepatectomy in a large cohort of HCC patients
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