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Surgical Endoscopy

, Volume 33, Issue 5, pp 1451–1458 | Cite as

Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

  • Giovanni Battista Levi SandriEmail author
  • Giuseppe Maria Ettorre
  • Luca AldrighettiEmail author
  • Umberto Cillo
  • Raffaele Dalla Valle
  • Alfredo Guglielmi
  • Vincenzo Mazzaferro
  • Alessandro Ferrero
  • Fabrizio Di Benedetto
  • Salvatore Gruttadauria
  • Luciano De Carlis
  • Giovanni Vennarecci
  • I Go MILS Group on HCC
Article

Abstract

Objective

Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality.

Methods

38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1.

Results

Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS.

Conclusions

These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.

Keywords

Laparoscopic HCC Posterior segment Hepatocellular carcinoma IGoMILS Child B Laparoscopic liver resection 

Notes

Acknowledgements

Collaborators of the I Go MILS Group on HCC: Adelmo Antonucci, (Policlinico di Monza, Monza); Giulio Belli, (Ospedale SM Loreto Nuovo, Napoli); Stefano Berti, (Ospedale Civile S. Andrea, La Spezia); Ugo Boggi, (AOU Pisana, Pisa); Pasquale Bonsignore, (IRCCS-ISMETT, Palermo); Alberto Brolese, (Ospedale S. Chiara, Trento); Fulvio Calise, (Ospedale Pinetagrande, Castel Volturno); Graziano Ceccarelli, (Ospedale San Donato, Arezzo); Michele Colledan, (AO Papa Giovanni XXIII, Bergamo); Andrea Coratti, (AOU Careggi, Firenze); Fabio Ferla, (ASST Grande Ospedale Metropolitano Niguarda, Milan); Antonio Floridi, (AO Ospedale Maggiore, Crema); Antonio Frena, (Ospedale Centrale, Bolzano); Antonio Giuliani, (AO R. N. Cardarelli, Napoli); Felice Giuliante, (Policlinico Gemelli, Rome); Gian Luca Grazi, (Istituto Nazionale Tumori Regina Elena, Roma); Enrico Gringeri, (University of Padua, Padova); Guido Griseri, (Ospedale San Paolo, Savona); Maurizio Iaria, (Parma University Hospital, Parma); Elio Jovine, (Ospedale Maggiore, Bologna); Magistri Paolo, (University of Modena and Reggio Emilia); Pietro Maida, (Ospedale Villa Betania, Napoli); Pietro Mezzatesta, (Casa di Cura La Maddalena, Palermo); Nadia Russolillo, (Ospedale Mauriziano Umberto I, Torino); Giuseppe Navarra, (AOU Policlinico G. Martino, Messina); Amilcare Parisi, (AO Santa Maria di Terni, Terni); Antonio Daniele Pinna, (Policlinico Sant’Orsola Malpighi, Bologna); Francesca Ratti, (IRCCS San Raffaele Hospital, Milano); Giorgio Ettore Rossi, (Policlinico di Milano, Milano); Andrea Ruzzenente, (University of Verona, Verona); Roberto Santambrogio, (AO San Paolo, Milano); Andrea Scotti, (San Camillo Hospital, Rome); Giovanni Sgroi, (AO Treviglio-Caravaggio, Treviglio); Abdallah Slim, (AO Desio e Vimercate, Vimercate); Guido Torzilli, (Istituto Clinico Humanitas, Rozzano); Leonardo Vincenti, (AOU Consorziale Policlinico, Bari); Matteo Virdis, (University of Milan, Milano) and Fausto Zamboni, (Ospedale Brotzu, Cagliari).

Compliance with ethical standards

Disclosure

Giovanni Battista Levi Sandri Giuseppe Maria Ettorre, Luca Aldrighetti, Umberto Cillo, Raffaele Dalla Valle, Alfredo Guglielmi, Vincenzo Mazzaferro, Alessandro Ferrero, Fabrizio Di Benedetto, Salvatore Gruttadauria, Luciano De Carlis, and Giovanni Vennarecci have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Giovanni Battista Levi Sandri
    • 1
    Email author
  • Giuseppe Maria Ettorre
    • 1
  • Luca Aldrighetti
    • 2
    Email author
  • Umberto Cillo
    • 3
  • Raffaele Dalla Valle
    • 4
  • Alfredo Guglielmi
    • 5
  • Vincenzo Mazzaferro
    • 6
  • Alessandro Ferrero
    • 7
  • Fabrizio Di Benedetto
    • 8
  • Salvatore Gruttadauria
    • 9
  • Luciano De Carlis
    • 10
  • Giovanni Vennarecci
    • 1
  • I Go MILS Group on HCC
  1. 1.Division of General Surgery and Liver TransplantationS. Camillo HospitalRomeItaly
  2. 2.Hepatobiliary SurgeryIRCCS San Raffaele HospitalMilanItaly
  3. 3.Department of Surgery, Oncology and GastroenterologyUniversity of PaduaPaduaItaly
  4. 4.Department of SurgeryParma University HospitalParmaItaly
  5. 5.Department of Hepatobiliary Surgery, G.B. Rossi HospitalUniversity of VeronaVeronaItaly
  6. 6.HPB Surgery and Liver Transplantation, Department of SurgeryUniversity of MilanMilanItaly
  7. 7.Department of HPB and Digestive SurgeryOspedale Mauriziano Umberto ITurinItaly
  8. 8.Hepato-Pancreato-Biliary Surgery and Liver Transplantation UnitUniversity of Modena and Reggio EmiliaModenaItaly
  9. 9.Abdominal Surgery and Organ Transplant Unit, Department for the Treatment and Study of Abdominal Diseases and Abdominal TransplantationMediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT)PalermoItaly
  10. 10.Surgical and Transplant DepartmentASST Grande Ospedale Metropolitano NiguardaMilanItaly

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