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World Journal of Surgery

, Volume 43, Issue 3, pp 878–885 | Cite as

Perioperative Outcomes of Laparoscopic Repeat Liver Resection for Recurrent HCC: Comparison with Open Repeat Liver Resection for Recurrent HCC and Laparoscopic Resection for Primary HCC

  • Brian K. P. GohEmail author
  • Nicholas Syn
  • Jin-Yao Teo
  • Yu-Xin Guo
  • Ser-Yee Lee
  • Peng-Chung Cheow
  • Pierce K. H. Chow
  • London L. P. J. Ooi
  • Alexander Y. F. Chung
  • Chung-Yip Chan
Original Scientific Report (including Papers Presented at Surgical Conferences)

Abstract

Background

This study aims to determine the safety and efficacy of laparoscopic repeat liver resection (LRLR) for recurrent hepatocellular carcinoma (rHCC).

Methods

Twenty patients underwent LRLR for rHCC between 2015 and 2017. The control groups consisted of 79 open RLR (ORLR) for rHCC and 185 LLR for primary HCC. We undertook propensity score-adjusted analyses (PSA) and 1:1 propensity score matching (PSM) for the comparison of LRLR versus ORLR. Comparison of LRLR versus LLR was done using multivariable regression models with adjustment for clinically relevant covariates.

Results

Twenty patients underwent LRLR with three open conversions (15%). Both PSA and 1:1-PSM demonstrated that LRLR was significantly associated with a shorter stay, superior disease-free survival (DFS) but longer operation time compared to ORLR. Comparison between LRLR versus LLR demonstrated that patients undergoing LRLR were significantly older, had smaller tumors, longer operation time and decreased frequency of Pringle’s maneuver applied. There was no difference in other key perioperative outcomes.

Conclusion

The results of this study demonstrate that in highly selected patients; LRLR for rHCC is feasible and safe. LRLR was associated with a shorter hospitalization but longer operation time compared to ORLR. Moreover, other than a longer operation time, LRLR was associated with similar perioperative outcomes compared to LLR for primary HCC.

Notes

Author contributions

BKG contributed to conception and design, analysis and interpretation of data, drafting of article, and final approval. NS worked for data acquisition, analysis and interpretation of data, and critical revision. JYT, SYL, CYC, and PCC were involved in data acquisition, conception and design, analysis and interpretation of data, critical revision of article, and final approval. YXG worked for data acquisition, analysis and interpretation of data, critical revision, and final approval. PKC performed analysis and interpretation of data, critical revision of article, and final approval. LLO contributed to conception and design, analysis and interpretation of data, critical revision of article, and final approval. AYC involved in data acquisition, conception and design, acquisition, analysis and interpretation of data, drafting of article, and final approval.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of interest or declarations in relation to this study.

Supplementary material

268_2018_4828_MOESM1_ESM.tif (4.6 mb)
Discriminatory Power of Propensity Score Model (TIFF 4705 kb)
268_2018_4828_MOESM2_ESM.tif (3.8 mb)
Distribution of Log Odds of Propensity Score after greedy matching (TIFF 3894 kb)
268_2018_4828_MOESM3_ESM.tif (3.1 mb)
Histogram of Propensity Score Differences after greedy matching (TIFF 3158 kb)

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Brian K. P. Goh
    • 1
    • 2
    Email author
  • Nicholas Syn
    • 3
  • Jin-Yao Teo
    • 1
  • Yu-Xin Guo
    • 1
  • Ser-Yee Lee
    • 1
  • Peng-Chung Cheow
    • 1
  • Pierce K. H. Chow
    • 1
  • London L. P. J. Ooi
    • 1
  • Alexander Y. F. Chung
    • 1
  • Chung-Yip Chan
    • 1
  1. 1.Department of Hepatopancreatobiliary and Transplant SurgerySingapore General HospitalSingaporeSingapore
  2. 2.Duke-NUS Medical SchoolSingaporeSingapore
  3. 3.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore

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