Short- and Long-Term Results of Laparoscopic Parenchyma-Sparing Hepatectomy for Small-Sized Hepatocellular Carcinoma: A Comparative Study Using Propensity Score Matching Analysis
The aim of this study was to evaluate the degree of invasiveness and the clinical outcomes of laparoscopic parenchyma-sparing hepatectomy (LPSH) for a maximum hepatocellular carcinoma (HCC) size ≤5 cm. Sixty-one LPSHs and 175 open parenchyma-sparing hepatectomies (OPSHs) for small-sized HCC were ana...
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| Veröffentlicht in: | The American surgeon 2018-02, Vol.84 (2), p.230-237 |
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| creator | Inoue, Yoshihiro Suzuki, Yusuke Ota, Masato Fujii, Kensuke Kawaguchi, Nao Hirokawa, Fumitoshi Hayashi, Michihiro Uchiyama, Kazuhisa |
| description | The aim of this study was to evaluate the degree of invasiveness and the clinical outcomes of laparoscopic parenchyma-sparing hepatectomy (LPSH) for a maximum hepatocellular carcinoma (HCC) size ≤5 cm. Sixty-one LPSHs and 175 open parenchyma-sparing hepatectomies (OPSHs) for small-sized HCC were analyzed using a propensity score matching analysis. The median operative time was significantly shorter in the LPSH group (194 min) than in the OPSH group (275 minutes) (P < 0.0001). The estimated blood loss was significantly lower in the LPSH group (100 mL) than in the OPSH group (380 mL) (P < 0.0001). The incidences of superficial incisional surgical site infections and respiratory complications were significantly lower in the LPSH group than in the OPSH group (P = 0.0161 and 0.0285, respectively). During the postoperative course, the white blood cell counts and C-reactive protein levels were significantly lower in the LPSH group. There were no differences in overall survival and disease-free survival (P = 0.1293 and 0.4039, respectively), and no significant differences in terms of type of recurrence and site of intrahepatic recurrence (P = 0.1410). The data from the present series suggest the lesser invasiveness and safety of LPSH even for small-sized HCC patients. |
| doi_str_mv | 10.1177/000313481808400230 |
| format | Article |
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Sixty-one LPSHs and 175 open parenchyma-sparing hepatectomies (OPSHs) for small-sized HCC were analyzed using a propensity score matching analysis. The median operative time was significantly shorter in the LPSH group (194 min) than in the OPSH group (275 minutes) (P < 0.0001). The estimated blood loss was significantly lower in the LPSH group (100 mL) than in the OPSH group (380 mL) (P < 0.0001). The incidences of superficial incisional surgical site infections and respiratory complications were significantly lower in the LPSH group than in the OPSH group (P = 0.0161 and 0.0285, respectively). During the postoperative course, the white blood cell counts and C-reactive protein levels were significantly lower in the LPSH group. There were no differences in overall survival and disease-free survival (P = 0.1293 and 0.4039, respectively), and no significant differences in terms of type of recurrence and site of intrahepatic recurrence (P = 0.1410). The data from the present series suggest the lesser invasiveness and safety of LPSH even for small-sized HCC patients.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313481808400230</identifier><identifier>PMID: 29580351</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Blood ; C-reactive protein ; Classification ; Clinical outcomes ; Comparative studies ; Complications ; Disease ; Hepatectomy ; Hepatocellular carcinoma ; Hospitals ; Invasiveness ; Laparoscopy ; Leukocytes ; Liver cancer ; Matching ; Medical prognosis ; Multivariate analysis ; Nosocomial infections ; Parenchyma ; Surgery ; Surgical site infections ; Survival ; Tumors ; Ultrasonic imaging ; Viral infections</subject><ispartof>The American surgeon, 2018-02, Vol.84 (2), p.230-237</ispartof><rights>2018 Southeastern Surgical Congress</rights><rights>Copyright Southeastern Surgical Congress Feb 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c481t-ddf5fbf652b3cb0da8af4db3f66956fff3abfbcf8ffa09e4148aa6479c8703f23</citedby><cites>FETCH-LOGICAL-c481t-ddf5fbf652b3cb0da8af4db3f66956fff3abfbcf8ffa09e4148aa6479c8703f23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/000313481808400230$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/000313481808400230$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29580351$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Inoue, Yoshihiro</creatorcontrib><creatorcontrib>Suzuki, Yusuke</creatorcontrib><creatorcontrib>Ota, Masato</creatorcontrib><creatorcontrib>Fujii, Kensuke</creatorcontrib><creatorcontrib>Kawaguchi, Nao</creatorcontrib><creatorcontrib>Hirokawa, Fumitoshi</creatorcontrib><creatorcontrib>Hayashi, Michihiro</creatorcontrib><creatorcontrib>Uchiyama, Kazuhisa</creatorcontrib><title>Short- and Long-Term Results of Laparoscopic Parenchyma-Sparing Hepatectomy for Small-Sized Hepatocellular Carcinoma: A Comparative Study Using Propensity Score Matching Analysis</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>The aim of this study was to evaluate the degree of invasiveness and the clinical outcomes of laparoscopic parenchyma-sparing hepatectomy (LPSH) for a maximum hepatocellular carcinoma (HCC) size ≤5 cm. 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The data from the present series suggest the lesser invasiveness and safety of LPSH even for small-sized HCC patients.</description><subject>Blood</subject><subject>C-reactive protein</subject><subject>Classification</subject><subject>Clinical outcomes</subject><subject>Comparative studies</subject><subject>Complications</subject><subject>Disease</subject><subject>Hepatectomy</subject><subject>Hepatocellular carcinoma</subject><subject>Hospitals</subject><subject>Invasiveness</subject><subject>Laparoscopy</subject><subject>Leukocytes</subject><subject>Liver cancer</subject><subject>Matching</subject><subject>Medical prognosis</subject><subject>Multivariate analysis</subject><subject>Nosocomial infections</subject><subject>Parenchyma</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Survival</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><subject>Viral 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Sixty-one LPSHs and 175 open parenchyma-sparing hepatectomies (OPSHs) for small-sized HCC were analyzed using a propensity score matching analysis. The median operative time was significantly shorter in the LPSH group (194 min) than in the OPSH group (275 minutes) (P < 0.0001). The estimated blood loss was significantly lower in the LPSH group (100 mL) than in the OPSH group (380 mL) (P < 0.0001). The incidences of superficial incisional surgical site infections and respiratory complications were significantly lower in the LPSH group than in the OPSH group (P = 0.0161 and 0.0285, respectively). During the postoperative course, the white blood cell counts and C-reactive protein levels were significantly lower in the LPSH group. There were no differences in overall survival and disease-free survival (P = 0.1293 and 0.4039, respectively), and no significant differences in terms of type of recurrence and site of intrahepatic recurrence (P = 0.1410). 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| ispartof | The American surgeon, 2018-02, Vol.84 (2), p.230-237 |
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| source | SAGE Complete A-Z List |
| subjects | Blood C-reactive protein Classification Clinical outcomes Comparative studies Complications Disease Hepatectomy Hepatocellular carcinoma Hospitals Invasiveness Laparoscopy Leukocytes Liver cancer Matching Medical prognosis Multivariate analysis Nosocomial infections Parenchyma Surgery Surgical site infections Survival Tumors Ultrasonic imaging Viral infections |
| title | Short- and Long-Term Results of Laparoscopic Parenchyma-Sparing Hepatectomy for Small-Sized Hepatocellular Carcinoma: A Comparative Study Using Propensity Score Matching Analysis |
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