Bae Se-Jong, Cho Hwui-Dong, Kim Ki-Hun, Hwang Shin, Ahn Chul-Soo, Moon Deok-Bog, Ha Tae-Yong, Song Gi-Won, Jung Dong-Hwan, Park Gil-Chun, Yoon Young-In, Lee Sung-Gyu
Division of Hepatobiliary Surgery and Liver transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Hepatobiliary Pancreat Surg. 2022 May 31;26(2):133-137. doi: 10.14701/ahbps.21-161.
BACKGROUNDS/AIMS: Anatomical resection has superior oncologic outcomes over non-anatomical resection in hepatocellular carcinoma, and left lateral sectionectomy is the simplest and easiest perform anatomical resection procedure among liver resections. The purpose of this study was to find out the safety and feasibility of pure laparoscopic left lateral sectionectomy (PLLLS) for hepatocellular carcinoma.
Patients who underwent left lateral sectionectomy at a tertiary referral hospital, from August 2007 to April 2019 were enrolled in this retrospective study. After matching the 1 : 3 propensity score, 17 open and 51 pure laparoscopic cases were selected out of 102 cases of total left lateral resection for hepatocellular carcinoma. The group was analyzed in terms of patient demographics, preoperative data, and postoperative outcomes.
During the study period, there was no open conversion case. The mean operative time and complication were not statistically significant different between the two groups. There was no statistically significant difference in disease-free survival and overall survival had no statistical between the two groups. There were no mortality cases, and postoperative hospital stay was significantly shorter in the PLLLS group than in the open left lateral sectionectomy (OLLS) group.
The oncologic outcomes and complication rate were the same in the PLLLS and OLLS groups. However, the hospital stay was shorter in the PLLLS group than in the OLLS group. The present study findings demonstrate that the PLLLS is a safe and feasible procedure for hepatocellular carcinoma.
背景/目的:在肝细胞癌中,解剖性切除比非解剖性切除具有更好的肿瘤学结局,而左外叶切除术是肝切除术中最简单、最容易实施的解剖性切除手术。本研究的目的是探讨纯腹腔镜左外叶切除术(PLLLS)治疗肝细胞癌的安全性和可行性。
选取2007年8月至2019年4月在一家三级转诊医院接受左外叶切除术的患者进行这项回顾性研究。在按照1:3倾向评分匹配后,从102例肝细胞癌左外叶切除术病例中选出17例开放手术病例和51例纯腹腔镜手术病例。对该组患者的人口统计学数据、术前资料和术后结局进行分析。
在研究期间,无开放手术中转病例。两组患者的平均手术时间和并发症发生率无统计学差异。两组患者的无病生存期和总生存期无统计学差异。无死亡病例,PLLLS组术后住院时间明显短于开放左外叶切除术(OLLS)组。
PLLLS组和OLLS组的肿瘤学结局和并发症发生率相同。然而,PLLLS组的住院时间比OLLS组短。本研究结果表明,PLLLS是一种治疗肝细胞癌安全可行的手术方法。