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Laparoscopic versus open repeat liver resection for recurrent hepatocellular carcinoma in hepatectomy patients: inverse probability of treatment weighting

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Abstract

Repeat liver resection (RLR) is a good treatment option for recurrent hepatocellular carcinoma (HCC). However, laparoscopic repeat liver resection (LRLR) is more technically demanding than open repeat liver resection (ORLR). The purpose of our study is to compare the surgical outcomes of ORLR and LRLR and to carefully present LRLR guidelines for HCC. We performed RLR at a single institution from January 2017 to November 2019. We divided the patients into an ORLR group and an LRLR group. Inverse probability of treatment weighting (IPTW) was applied in this study to compare the ORLR group and the LRLR group. There was no difference between the two groups in patient characteristics, preoperative blood tests and pathological characteristics. After stabilized IPTW, the LRLR group had a shorter hospital stay (5.52 vs. 9.27 days, p = 0.001) and superior disease-free survival (p = 0.020). LRLR yielded better short-term outcomes than ORLR. And if a regular radiologic examination is performed, most of the recurrent tumors could be detected less than 3 cm. In conclusion, LRLR might be feasible and useful for recurrent HCC located contralateral to the previous tumor at a size of less than 3 cm.

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Abbreviations

HCC:

Hepatocellular carcinoma

RLR:

Repeat liver resection

LLR:

Laparoscopic liver resection

LPLR:

Laparoscopic primary liver resection

LRLR:

Laparoscopic repeat liver resection

ORLR:

Open repeat liver resection

BMI:

Body mass index

ASA:

American Society of Anesthesiologists

IPTW:

Inverse probability of treatment weighting

SMD:

Standardized mean differences

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Authors and Affiliations

  1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

    Eun Sung Jeong, Jong Man Kim, Manuel Lim, Jaehun Yang, Ji Eun Kwon, Gyu-Seong Choi & Jae-Won Joh

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  1. Eun Sung Jeong
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  2. Jong Man Kim
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  3. Manuel Lim
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  4. Jaehun Yang
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  5. Ji Eun Kwon
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  6. Gyu-Seong Choi
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  7. Jae-Won Joh
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Contributions

ESJ: acquisition of data, analysis and interpretation of data, and writing of the manuscript. JMK: design, analysis and interpretation of data, and writing of the manuscript. ML, JY, JEK, G-SC, and J-WJ: acquisition of data.

Corresponding author

Correspondence to Jong Man Kim.

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This study was approved by the Samsung Medical Center Institutional Review Board (IRB) (SMC-2020-01-071).

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Jeong, E.S., Kim, J.M., Lim, M. et al. Laparoscopic versus open repeat liver resection for recurrent hepatocellular carcinoma in hepatectomy patients: inverse probability of treatment weighting. Updates Surg 74, 527–534 (2022). https://doi.org/10.1007/s13304-022-01257-x

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  • DOI: https://doi.org/10.1007/s13304-022-01257-x

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