Background: This study aimed to evaluate the perioperative outcomes of patients with benign and malignant liver lesions scheduled for laparoscopic and open surgery using a propensity score-matched approach to analyze additional cofactors influencing outcomes.
Patients And Methods: In this study, we retrospectively reviewed 270 patients who underwent laparoscopic or open liver resection at our institute between October 2016 and November 2021. Patients were divided into open and laparoscopic liver resection groups and compared according to the intention to treat principle. In the purification process for the nonrandom nature of the study, a matching analysis was performed at a 1:1 case-control ratio. The PS model included selected data on body mass index, additional data on the American Society of Anesthesiology score, cirrhosis, lesion <2 cm from the hilum, lesion <2 cm from the hepatic vein or inferior vena cava, and type of neoadjuvant chemotherapy.
Results: The operation time and 30- and 90-day mortality rates were similar between the groups. The average length of hospital stay was 11 days in the open surgery group and 9 days in the laparoscopic surgery group after matching ( P =0.011). The 30-day morbidity rate was statistically different between the groups before and after matching, favoring the laparoscopic group ( P =0.001 and 0.006, respectively). After the propensity score-matched approch, the open group's Pringle time was shorter than that of the laparoscopic group. The total operative time was longer in the laparoscopic than in the open surgery group. This did not change after matching (300 vs. 240 min).
Conclusions: Laparoscopic surgery is a feasible and safe treatment option for patients with liver tumors, with promising results in terms of morbidity and hospital stay.
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http://dx.doi.org/10.1097/SLE.0000000000001190 | DOI Listing |
Bull Exp Biol Med
January 2025
N. N. Burdenko Voronezh State Medical University, Voronezh, Russia.
A method of intraoperative modeling of liver cirrhosis in an experiment has been developed. Mature male Wistar rats underwent typical liver resection (~70% of the initial volume). After resection, intrahepatic injection of 1 ml ademetionine was performed (controls received 0.
View Article and Find Full Text PDFHepatol Int
January 2025
Department of Hepatobiliary Surgery, Mengchao Hepatobiliary Hospital of Fujian Medical University, Fuzhou, 350025, China.
Background: Large hepatocellular carcinoma (HCC) is difficult to resect and accompanied by poor outcome. The aim was to evaluate the short-term and long-term outcomes of patients who underwent liver resection for large HCC, eventually drawing prediction models for short-term and long-term outcomes.
Methods: 1710 large HCC patients were recruited and randomly divided into the training (n = 1140) and validation (n = 570) cohorts in a 2:1 ratio.
Ann Gastroenterol Surg
January 2025
Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Aims: Liver fibrosis predisposes patients to liver failure and hepatocellular carcinoma. Various markers, which can be calculated easily from serum parameters, have been reported to predict liver fibrosis accurately. This study investigated the prognostic factors, including blood-based markers for liver fibrosis of patients with hepatocellular carcinoma following initial curative hepatectomy.
View Article and Find Full Text PDFAnn Gastroenterol Surg
January 2025
Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery Shinshu University School of Medicine Matsumoto Japan.
Background And Aim: Post-hepatectomy liver failure (PHLF) after major hepatopancreatoduodenectomy (HPD) is a challenge to overcome. However, the appropriate target proportion of the future liver remnant (pFLR) to prevent severe PHLF in major HPD remains uncertain. This study aimed to determine the minimum pFLR required for safe major HPD.
View Article and Find Full Text PDFAnn Gastroenterol Surg
January 2025
Department of Gastroenterological and Transplant Surgery Applied Life Sciences, Institute of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
Aim: We previously reported that abdominal aortic calcification is associated with poor overall and recurrence-free survival after hepatectomy for hepatocellular carcinoma (HCC). However, the effect of abdominal aortic calcification on cancer-specific prognosis in very old patients with several comorbidities remains unknown. This multicenter study aimed to evaluate the impact of abdominal aortic calcification on the cumulative recurrence rate and recurrence-free survival in patients with HCC aged >80 years.
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