Long Tran Cong Duy, MD. HPB Department University Medical Center in Hochiminh city
Background: HCC is common cancer, especially in ASEAN region where the prevelence of hepatitis virus infection is high. Liver resection is the curative and popularized therapy for HCC. Laparoscopic surgery, with minimally invasive techniques, potentially brings benefits to patients who need liver resection for HCC. The aim of our study is to evaluate the effectiveness, safety and benefits of laparoscopic liver resection for HCC with long-term results.
Patients and Methods: This is a Cohort study with 5-year results of total laparoscopic hepatectomy for HCC in one center. Patients with HCC were selected for laparoscopic liver resection by the same team. The operation was also performed by one team for surgeon. The follow-up protocol was similar to the open surgery. The patients would come back for examination every 2 months after that. Data of patients was collected and analised using SPSS software.
Results: From Jan 2007 to Jul 2014, we had 275 enrolled patients with HCC underwent laparoscopic liver resection. Male/Female: 3/1. Mean of age: 55.81 ± 11.5 years old. Follow-up was fullfiled in 130 patients for 21.6 ± 16.0 months (0-60 months). Mean tumor size was 3.73 cm (2-10 cm). Stage of HCC (according to BCLC): 0 (13.8%), A1 (55.4%), A2 (9.6%), and B (21.2%). We had to convert to other technique in 11 patients (4%) because potential of major bleeding and tumor perforation. Type of resection: one segment (45%), two segments (45%), three segments(6.5%) and four segments(3.5%). Mean operation time: 120 minute (30 – 345 minute). Median blood loss 100 ml (20-1200 ml). Mean hospiatl stay: 6 days (3-25 days). There was no perioperative mortality. The complication after surgery: bleeding (08%), transient liver failure (08%), Bile leakage (08%),…The classification of complication according to Clavien were: I (214 patients , 83,5%), II (44 patients, 16,9%), IIIA (1 patients, 0,3%). The disease free survival at 1, 2, 3, 4, 5 years in this study was 79.3%, 64.5%, 56.0%, 51.2% and 46.8% respectively. The mean disease-free survival: 69.43 ± 2.97 months. The overall survival at 1, 2, 3, 4, 5 years is 96.4%, 84.0%, 78.7%, 77.3% and 77.3% respectively
Conclusion: Laparoscopic liver resection for HCC is feasible, safe, and effective with good oncologic results. Major and anatomic hepatectomy can be performed more usual by improving skill and experience. Laparoscopic liver resection become promising potental treatment with mini invasive benefit for HCC patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80870
Program Number: S058
Presentation Session: HPB
Presentation Type: Podium