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Long-term and short-term surgical outcomes of single-incision laparoscopic hepatectomy on anterolateral liver segments

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Abstract

Background

Laparoscopic liver resection yields improved short-term surgical outcomes, whereas the reports about clinical benefits of single-incision laparoscopic hepatectomy (SILH) are scarce. This retrospective study is to compare the surgical outcomes of SILH with those of multi-incision laparoscopic hepatectomy (MILH).

Methods

The study included 54 patients who had undergone SILH and 184 patients who had undergone MILH between January 2010 and December 2017. Short-term outcomes were compared in those of patients who underwent left lateral sectionectomy and partial hepatectomy of segment 5–6. A subgroup analysis of hepatocellular carcinoma (HCC) was also performed for long-term outcome comparisons.

Results

In those of patients who underwent left lateral sectionectomy, SILH group had less chronic hepatitis B (15.2 vs. 45.8%; p = 0.004), less liver cirrhosis (12.1 vs. 50.0%; p = 0.002), less tumor proximal to major vessel (6.1 vs. 29.2%; p = 0.018), shorter surgical time (113.2 ± 37.9 vs. 146.0 ± 50.5 min; p = 0.007), and shorter postoperative hospital stays (4.4 ± 1.1 vs. 5.4 ± 1.3 days; p = 0.002) compared with MILH group. In those of patients with tumor located at segment 5–6, no significant differences were observed in surgical time, blood loss, complications, and mortality. Single-incision laparoscopic partial hepatectomy was only associated with wider surgical margins (11.8 ± 7.0 vs. 5.3 ± 5.2 mm; p = 0.003). In the HCC subgroup, SILH had similar 1-, 3-, and 5-year overall survival and 1-, 3-, and 5-year recurrence-free survival rates compared with patients who had undergone MILH.

Conclusions

The study demonstrates the safety and feasibility of single-incision laparoscopic liver resection for left lateral sectionectomy and partial hepatectomy for segment 5–6. In selected patients within the group and by experienced surgical team, the SILH technique results in comparable short-term surgical outcomes and long-term oncological outcomes.

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Acknowledgments

This manuscript was edited by Wallace Academic Editing.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Taipei Medical University Shuang Ho Hospital, No. 291, Zhongzheng Rd., Zhonghe District, New Taipei City, 235, Taiwan

    Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang & Ming-Te Huang

  2. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang & Ming-Te Huang

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  1. Kuei-Yen Tsai
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  2. Hsin-An Chen
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Correspondence to Ming-Te Huang.

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Drs. Kuei-Yen Tsai, Hsin-An Chen, Wan-Yu Wang, and Ming-Te Huang have no conflicts of interest or financial ties to disclose.

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Tsai, KY., Chen, HA., Wang, WY. et al. Long-term and short-term surgical outcomes of single-incision laparoscopic hepatectomy on anterolateral liver segments. Surg Endosc 34, 2969–2979 (2020). https://doi.org/10.1007/s00464-019-07080-7

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  • DOI: https://doi.org/10.1007/s00464-019-07080-7

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