Satoru Imura, Atsushi Takata, Toshiaki Yoshimoto, Masato Yoshikawa, Hiroki Teraoku, Daichi Ishikawa, Yu Saito, Shuichi Iwahashi, Tetsuya Ikemoto, Yuji Morine, Mitsuo Shimada. Tokushima University
INTRODUCTION: With progress of surgical technique and devices, laparoscopic liver resection (LR) became a realizable option for patients with hepatocellular carcinoma (HCC). However, the feasibility of LR for HCC should be guaranteed also oncologically. In Japan, only partial resection and left lateral segmentectomy had been covered by the insurance system until recently. Herein, we evaluate the short and long term outcome of laparoscopic partial liver resection compared with open method (OR) for HCC patients by matched pair analysis.
METHODS AND PROCEDURES: Until March 2015, 15 consecutive HCC patients who underwent LR were compared in a retrospective analysis with a historic group of 45 patients who underwent OR. The two groups were well matched for age, gender, tumor location and size, and severity of cirrhosis. The selection criteria of HCC for both groups specified a small (size <5 cm), in the left or peripheral right segments of the liver (Couinaud’s segment: II-VI, VIII).
RESULTS: The mean age was similar in both groups (LR: 66yr [41-83], OH: 67yr [38-86]). All patients were Child-Pugh A. The mean operative time was similar in both groups (LH: 271min [184-404], OH: 294min [135-501]). The mean blood loss in the LR group was tended to be less than OR group (169ml [0-1500] vs 304ml [23-1530], p=0.10). The mean hospital stay in the LR group was significantly shorter than OR group (15days vs. 23days, p<0.05). There was no significant difference in the incidence of postoperative complication. Critical complication was not observed except 1 case of gas embolism in the LH group (emergent conversion to laparotomy). Overall survival rate was 78% at 3-year, 78% at 5-year in LR group and 85% at 3-year, 81% at 5-year in OH group. Disease-free survival rate was 57% at 1-year, 57% at 3-year in LR group and 75% at 1-year, 42% at 3-year in OR group. There was no significant difference in overall and disease-free survival between the two groups.
CONCLUSION: Outcome of laparoscopic partial liver resection for small HCC including long-term survival was acceptable.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79731
Program Number: P469
Presentation Session: Poster (Non CME)
Presentation Type: Poster