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Perioperative and oncological outcomes of laparoscopic anatomical hepatectomy for hepatocellular carcinoma introduced gradually in a single center

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Abstract

Background

Anatomical hepatectomy is an ideal curative treatment for hepatocellular carcinoma (HCC). We have standardized our laparoscopic anatomical hepatectomy (LAH) procedure, gradually extending its indications. In the present study, we describe our experience and the perioperative and oncological outcomes of LAH for HCC compared to those of open anatomical hepatectomy (OAH) during the gradual introduction of LAH.

Methods

Seventy patients with primary HCC underwent anatomical hepatectomy in our institution from November 2008 to April 2014. As we gained experience with LAH, our indications for choosing LAH over OAH gradually expanded. Ultimately, 40 and 30 patients underwent LAH and OAH, respectively. Perioperative and oncological outcomes were compared between the two groups.

Results

There were no significant differences in age, sex, background of liver disease, liver function, tumor size, tumor number, or type of liver resection between the two groups. Major complications and mortality rates were similar between the LAH and OAH groups (12.5% vs. 20%; p = 0.582, and 0% vs. 3.3%; p = 0.429, respectively). The median follow-up time after surgery was 40.5 months in the LAH group and 32.9 months in the OAH group (p = 0.835). The 1-, 3-, and 5-year overall survival rates were 89.9, 84.7, and 70.9%, in the LAH group, and 89.8, 68.0, and 63.1% in the OAH group, respectively (p = 0.255). The 1-, 3-, and 5-year disease-free survival rates were 79.5, 58.0, and 42.5%, in the LAH group, and 72.4, 56.1, and 50.4% in the OAH group, respectively (p = 0.980).

Conclusions

Through gradual introduction of LAH, we obtained comparable results to those achieved with OAH. LAH can be a feasible surgical treatment for primary HCC, with good oncological outcomes.

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Disclosures

Goro Honda has received lecture fees from Johnson & Johnson and Covidien. Tomoki Ryu, Masanao Kurata, Shin Kobayashi, Katsunori Sakamoto, and Masahiko Honjo have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113-8677, Japan

    Tomoki Ryu, Goro Honda, Masanao Kurata, Shin Kobayashi, Katsunori Sakamoto & Masahiko Honjo

  2. Department of Hepato-biliary-Pancreatic Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan

    Tomoki Ryu

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  1. Tomoki Ryu
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  2. Goro Honda
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Correspondence to Goro Honda.

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Ryu, T., Honda, G., Kurata, M. et al. Perioperative and oncological outcomes of laparoscopic anatomical hepatectomy for hepatocellular carcinoma introduced gradually in a single center. Surg Endosc 32, 790–798 (2018). https://doi.org/10.1007/s00464-017-5745-0

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