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Laparoscopic repeat hepatectomy is a more favorable treatment than open repeat hepatectomy for contralateral recurrent hepatocellular carcinoma cases

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Abstract

Background

We compared surgical outcomes, with a focus on tumor characteristics, of laparoscopic repeat hepatectomy (LRH) and open repeat hepatectomy (ORH) to identify recurrent hepatocellular carcinoma (HCC) cases where the LRH procedure would be more favorable than ORH.

Methods

Eighty-one HCC patients who underwent repeat hepatectomy in our hospital from 2008 to 2019 were retrospectively analyzed in this study. Of these patients, 30 and 51 patients underwent LRH and ORH, respectively. We analyzed surgical outcomes of LRH and ORH, focusing on tumor characteristics such as tumor size, location, distance from major vessels, and contralateral or ipsilateral tumor recurrence to determine what factors could affect surgical outcomes. Subsequently, using a propensity-matched cohort, we compared the impact of those factors on LRH and ORH outcomes.

Results

In the entire cohort, the LRH operation time was significantly shorter in contralateral recurrent HCC cases than in ipsilateral recurrent HCC cases (252 vs. 398 min, P = 0.008); however, such a difference was not observed in the ORH operation time. We subsequently compared the surgical outcomes, in terms of the location of tumor recurrence, between the LRH and ORH groups in a propensity-matched cohort. In total, 23 patients were included in each of these groups. We found that the LRH procedure had significantly shorter operative time than the ORH procedure in the contralateral recurrent HCC cases (253 vs. 391 min, P = 0.018); however, we did not observe such a difference in the ipsilateral recurrent HCC cases (372 vs. 333 min, P = 0.669). LRH had lower blood loss, similar postoperative complications and shorter hospital stay than ORH in both contralateral and ipsilateral recurrent HCC cases.

Conclusions

LRH is likely considered a more favorable approach than ORH in treating patients with contralateral recurrent HCC.

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Acknowledgements

We would like to thank S. Murakami for help with the statistical analyses.

Funding

The authors have no source of funding to declare.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Hidetoshi Gon, Masahiro Kido, Motofumi Tanaka, Kaori Kuramitsu, Shohei Komatsu, Masahide Awazu, Shinichi So, Hirochika Toyama & Takumi Fukumoto

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  1. Hidetoshi Gon
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  2. Masahiro Kido
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  3. Motofumi Tanaka
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  4. Kaori Kuramitsu
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  5. Shohei Komatsu
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  6. Masahide Awazu
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  7. Shinichi So
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  8. Hirochika Toyama
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  9. Takumi Fukumoto
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Corresponding author

Correspondence to Hidetoshi Gon.

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Disclosures

Drs. H Gon, M Kido, M Tanaka, K Kuramitsu, S Komatsu, M Awazu, S So, H Toyama, and T Fukumoto have no conflicts of interest or financial ties to disclose.

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Gon, H., Kido, M., Tanaka, M. et al. Laparoscopic repeat hepatectomy is a more favorable treatment than open repeat hepatectomy for contralateral recurrent hepatocellular carcinoma cases. Surg Endosc 35, 2896–2906 (2021). https://doi.org/10.1007/s00464-020-07728-9

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  • DOI: https://doi.org/10.1007/s00464-020-07728-9

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