Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study
Abstract Aim This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). Methods The clinical records of 339 and 733 patient...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.12506 |
| _version_ | 1828893311840026624 |
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| author | Atsushi Ishihara Shogo Tanaka Hiroji Shinkawa Hisako Yoshida Shigekazu Takemura Ryosuke Amano Kenjiro Kimura Go Ohira Kohei Nishio Shoji Kubo |
| author_facet | Atsushi Ishihara Shogo Tanaka Hiroji Shinkawa Hisako Yoshida Shigekazu Takemura Ryosuke Amano Kenjiro Kimura Go Ohira Kohei Nishio Shoji Kubo |
| author_sort | Atsushi Ishihara |
| collection | DOAJ |
| description | Abstract Aim This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). Methods The clinical records of 339 and 733 patients who underwent LLR and OLR, respectively, for HCC between 2000 and 2019 were retrospectively reviewed. Body mass index (BMI) groups were classified according to the definitions of the World Health Organization: underweight group, BMI ≤ 18.4 kg/m2 (LLR vs OLR: 27 vs 47); normal weight, BMI 18.5‐24.9 kg/m2 (211 vs 483); overweight, BMI 25.0‐29.9 kg/m2 (85 vs 181); and obese, BMI ≥ 30.0 kg/m2 (16 vs 22). The effects of obesity on major complications after LLR and OLR were investigated. Results In total, 18 (5.3%) and 127 (17.3%) patients presented with major complications after LLR and OLR, respectively. There was no significant difference in the incidence of major complications after OLR in the four BMI groups. However, a stepwise decrease in the incidence of major complications after LLR was observed from the underweight to the obese group. In addition, a multivariate analysis revealed that increased BMI was an independent preventive factor for major complications after LLR (P = .026, odds ratio: 0.84). The estimated adjusted risk of major postoperative complications decreased with increased BMI in the LLR group, while the risk did not decrease in the OLR group (P for interaction = .048). Conclusion Laparoscopic liver resection is beneficial for obese patients and is superior to OLR. |
| first_indexed | 2024-12-13T13:51:32Z |
| format | Article |
| id | doaj.art-2bd90aa6226149f89e563019a504cffa |
| institution | Directory Open Access Journal |
| issn | 2475-0328 |
| language | English |
| last_indexed | 2024-12-13T13:51:32Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj.art-2bd90aa6226149f89e563019a504cffa2022-12-21T23:43:07ZengWileyAnnals of Gastroenterological Surgery2475-03282022-01-016113514810.1002/ags3.12506Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective studyAtsushi Ishihara0Shogo Tanaka1Hiroji Shinkawa2Hisako Yoshida3Shigekazu Takemura4Ryosuke Amano5Kenjiro Kimura6Go Ohira7Kohei Nishio8Shoji Kubo9Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Medical Statistics Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanDepartment of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka JapanAbstract Aim This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). Methods The clinical records of 339 and 733 patients who underwent LLR and OLR, respectively, for HCC between 2000 and 2019 were retrospectively reviewed. Body mass index (BMI) groups were classified according to the definitions of the World Health Organization: underweight group, BMI ≤ 18.4 kg/m2 (LLR vs OLR: 27 vs 47); normal weight, BMI 18.5‐24.9 kg/m2 (211 vs 483); overweight, BMI 25.0‐29.9 kg/m2 (85 vs 181); and obese, BMI ≥ 30.0 kg/m2 (16 vs 22). The effects of obesity on major complications after LLR and OLR were investigated. Results In total, 18 (5.3%) and 127 (17.3%) patients presented with major complications after LLR and OLR, respectively. There was no significant difference in the incidence of major complications after OLR in the four BMI groups. However, a stepwise decrease in the incidence of major complications after LLR was observed from the underweight to the obese group. In addition, a multivariate analysis revealed that increased BMI was an independent preventive factor for major complications after LLR (P = .026, odds ratio: 0.84). The estimated adjusted risk of major postoperative complications decreased with increased BMI in the LLR group, while the risk did not decrease in the OLR group (P for interaction = .048). Conclusion Laparoscopic liver resection is beneficial for obese patients and is superior to OLR.https://doi.org/10.1002/ags3.12506body mass indexhepatectomylaparoscopic liver resectionobesitypostoperative complication |
| spellingShingle | Atsushi Ishihara Shogo Tanaka Hiroji Shinkawa Hisako Yoshida Shigekazu Takemura Ryosuke Amano Kenjiro Kimura Go Ohira Kohei Nishio Shoji Kubo Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study Annals of Gastroenterological Surgery body mass index hepatectomy laparoscopic liver resection obesity postoperative complication |
| title | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
| title_full | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
| title_fullStr | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
| title_full_unstemmed | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
| title_short | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
| title_sort | superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma a retrospective study |
| topic | body mass index hepatectomy laparoscopic liver resection obesity postoperative complication |
| url | https://doi.org/10.1002/ags3.12506 |
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