Jai Young Cho, Hanisah Guro, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jae Seong Jang, Seong Uk Kwon, Sungho Kim, Jang Kyu Choi, Mohan Periyasamy. Department of Surgery, Seoul National University Bundang Hospital, Republic of Korea
BACKGROUND: Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) located in the segment 7 or 8 is considered as unfavorable location for LLR. We evaluate the safety of LLR in the segment 7 or 8 with applying new techniques.
METHODS: This retrospective study 104 patients who underwent LLR or open liver resection (OLR) for HCC located in segment 7 or 8 between October 2004 and June 2015. The patients were divided into two groups; LLR group (n=46) and OLR group (n=58) according to the type of operation. The laparoscopic group was further subdivided into two groups according to the time period after introducing Pringle maneuver, intercostal trocars, and semi-lateral patient positioning; Lap 1(n=29) and Lap 2 (n=17).
RESULTS: There were no significant differences in preoperative patients’ characteristics between two groups. The LLR group underwent more non-anatomic LLR (P<0.001) in smaller tumor size (P<0.001) compared with the OLR group. There were no significant differences in terms of blood transfusion (P=0.526), operation time (P=0.267), postoperative complication (P=0.051), and resection margin (P=0.705). However, LLR group showed less blood loss (P=0.030) and shorter hospital stay (P=0.001). The 3 year overall patient survival (P=0.096) and 3 year disease-free survival (P=0.857) were also similar between two groups. In the laparoscopic subgroups, Lap 2 showed that less blood loss (P=0.005) and shorter hospital stay (P=0.038) compared with the Lap1 group.
CONCLUSION: LLR for HCC located in segment 7 or 8 can be safely performed with recent improvement of technique and accumulation of experience.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77389
Program Number: S090
Presentation Session: Plenary 1
Presentation Type: Podium