A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques
<i>Background and Objectives</i>: Laparoscopic liver resection (LLR) for the hepatocellular carcinoma (HCC) located in posterosuperior (PS) segment is technically demanding, but has been overcome by accumulated experiences and technological improvements. We analyzed peri-and post-operati...
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MDPI AG
2022-04-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/4/543 |
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| author | Yujin Kwon Boram Lee Jai Young Cho Ho-Seong Han Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Munwhan Kim Youngsoo Jo |
| author_facet | Yujin Kwon Boram Lee Jai Young Cho Ho-Seong Han Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Munwhan Kim Youngsoo Jo |
| author_sort | Yujin Kwon |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Laparoscopic liver resection (LLR) for the hepatocellular carcinoma (HCC) located in posterosuperior (PS) segment is technically demanding, but has been overcome by accumulated experiences and technological improvements. We analyzed peri-and post-operative results before and after the adaptation of the enhanced techniques. <i>Materials and Methods</i>: We retrospectively reviewed 246 patients who underwent LLR for HCC in PS segments from September 2003 to December 2019. According to the introduction of advanced techniques including intercostal trocars, Pringle maneuver, and semi-lateral French position, the patients were divided into Group 1 (<i>n</i> = 43), who underwent LLR from September 2003 to December 2011, and Group 2 (<i>n</i> = 203), who underwent LLR from January 2012 to December 2019. Among these cases, 136 patients (Group 1 = 34, Group 2 = 102) were selected by case-matched analysis using perioperative variables. <i>Results:</i> Mean operation time (362 min vs. 291 min) and hospital stay (11 days vs. 8 days, <i>p</i> = 0.023) were significantly longer in Group 1 than Group 2. Otherwise, disease-free survival (DFS) rate was shorter and resection margin (1.3 mm vs. 0.7 mm, <i>p</i> = 0.034) were smaller in Group 2 than Group 1. However, there was no difference in type of complication (<i>p</i> = 0.084), severity of complication graded by the Clavien–Dindo grade system (<i>p</i> = 0.394), and 5-year overall survival (OS) rates (<i>p</i> = 0.986). In case-matched analysis, operation time (359 min vs. 266 min <i>p</i> = 0.002) and hospital stay (11.5 days vs. 8.0 days, <i>p</i> = 0.032) were significantly different, but there was no significant difference in resection margin, DFS, and OS. <i>Conclusions</i>: The adaptation of improved techniques has reduced the complexity of LLR in PS segments. |
| first_indexed | 2024-03-09T04:24:38Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T04:24:38Z |
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| spelling | doaj.art-2c6adca8c8eb4c35803bacb34a2fabba2023-12-03T13:41:25ZengMDPI AGMedicina1010-660X1648-91442022-04-0158454310.3390/medicina58040543A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed TechniquesYujin Kwon0Boram Lee1Jai Young Cho2Ho-Seong Han3Yoo-Seok Yoon4Hae Won Lee5Jun Suh Lee6Munwhan Kim7Youngsoo Jo8Department of Surgery, Seoul Medical Center, Seoul 02053, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, KoreaDepartment of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul 13620, Korea<i>Background and Objectives</i>: Laparoscopic liver resection (LLR) for the hepatocellular carcinoma (HCC) located in posterosuperior (PS) segment is technically demanding, but has been overcome by accumulated experiences and technological improvements. We analyzed peri-and post-operative results before and after the adaptation of the enhanced techniques. <i>Materials and Methods</i>: We retrospectively reviewed 246 patients who underwent LLR for HCC in PS segments from September 2003 to December 2019. According to the introduction of advanced techniques including intercostal trocars, Pringle maneuver, and semi-lateral French position, the patients were divided into Group 1 (<i>n</i> = 43), who underwent LLR from September 2003 to December 2011, and Group 2 (<i>n</i> = 203), who underwent LLR from January 2012 to December 2019. Among these cases, 136 patients (Group 1 = 34, Group 2 = 102) were selected by case-matched analysis using perioperative variables. <i>Results:</i> Mean operation time (362 min vs. 291 min) and hospital stay (11 days vs. 8 days, <i>p</i> = 0.023) were significantly longer in Group 1 than Group 2. Otherwise, disease-free survival (DFS) rate was shorter and resection margin (1.3 mm vs. 0.7 mm, <i>p</i> = 0.034) were smaller in Group 2 than Group 1. However, there was no difference in type of complication (<i>p</i> = 0.084), severity of complication graded by the Clavien–Dindo grade system (<i>p</i> = 0.394), and 5-year overall survival (OS) rates (<i>p</i> = 0.986). In case-matched analysis, operation time (359 min vs. 266 min <i>p</i> = 0.002) and hospital stay (11.5 days vs. 8.0 days, <i>p</i> = 0.032) were significantly different, but there was no significant difference in resection margin, DFS, and OS. <i>Conclusions</i>: The adaptation of improved techniques has reduced the complexity of LLR in PS segments.https://www.mdpi.com/1648-9144/58/4/543hepatectomyprognosiscomplicationsurvival |
| spellingShingle | Yujin Kwon Boram Lee Jai Young Cho Ho-Seong Han Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Munwhan Kim Youngsoo Jo A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques Medicina hepatectomy prognosis complication survival |
| title | A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques |
| title_full | A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques |
| title_fullStr | A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques |
| title_full_unstemmed | A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques |
| title_short | A Case-Matched Analysis of Laparoscopic Liver Resection for Hepatocellular Carcinoma Located in Posterosuperior Segments of the Liver According to Adaption of Developed Techniques |
| title_sort | case matched analysis of laparoscopic liver resection for hepatocellular carcinoma located in posterosuperior segments of the liver according to adaption of developed techniques |
| topic | hepatectomy prognosis complication survival |
| url | https://www.mdpi.com/1648-9144/58/4/543 |
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