Laparoscopic liver resection for treating recurrent hepatocellular carcinoma

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 20; no. 5; pp. 512 - 517
• Main Authors: Kanazawa, Akishige, Tsukamoto, Tadashi, Shimizu, Sadatoshi, Kodai, Shintaro, Yamamoto, Satoshi, Yamazoe, Sadaaki, Ohira, Go, Nakajima, Takayoshi
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01-06-2013; Springer Japan; Wiley Subscription Services, Inc
• Subjects: Abdominal Surgery; Aged; Aged, 80 and over; ascites; Blood Loss, Surgical - statistics & numerical data; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Female; Gastroenterology; Hepatectomy - methods; hepatocellular carcinoma recurrence; Hepatology; Humans; Incidence; Japan - epidemiology; laparoscopic liver resection; Laparoscopy; Laparoscopy - methods; Length of Stay - statistics & numerical data; Liver cancer; Liver cirrhosis; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - surgery; Original Article; Postoperative Complications - epidemiology; Reoperation; repeated hepatectomy; Retrospective Studies; Risk Factors; SSI; Surgical Oncology; Treatment Outcome; Japan; Laparoscopic liver resection; Hepatocellular carcinoma recurrence; SSI; Repeated hepatectomy; Ascites
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1007/s00534-012-0592-9

Background
It is still unknown whether laparoscopic liver resection is suitable for recurrent hepatocellular carcinoma (HCC) after previous curative hepatic resection.
Method
The perioperative outcomes of 40 patients treated with second surgery for recurrent HCC by partial hepatectomy were studied retrospectively. The second surgery was performed under laparotomy in 20 patients (laparotomy group) and under laparoscopy in 20 patients (laparoscopy group).
Results
Intraoperative blood loss (
p
 < 0.0001) and the incidence of postoperative complications (
p
 = 0.0004) were lower in the laparoscopy group than in the laparotomy group. The incidence rates of surgical site infection and intractable ascites were significantly higher in the laparotomy group than in the laparoscopy group (
p
 = 0.0202,
p
 = 0.0436, respectively). The proportion of patients classified as Clavien grade IIIa was higher in the laparotomy group than in the laparoscopy group (
p
 = 0.0033). The duration of the postoperative hospital stay was significantly shorter in the laparoscopy group than in the laparotomy group (
p
 < 0.0001).
Conclusions
Postoperative morbidity has been decreased by the introduction of laparoscopic liver resection in patients with recurrent HCC after curative hepatic resection. As a result, the duration of the postoperative stay is shorter.