Short-term surgical outcomes of minimally invasive repeat hepatectomy for recurrent liver cancer

Takehiro Noda, Hidetoshi Eguchi, Hiroshi Wada, Yoshifumi Iwagami, Daisaku Yamada, Tadafumi Asaoka, Kunihito Gotoh, Koichi Kawamoto, Yutaka Takeda, Masahiro Tanemura, Koji Umeshita, Yuichiro Doki, Masaki Mori

Research output: Contribution to journalArticle

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Abstract

Background: Repeat liver resection is an effective treatment, with long-term surgical outcomes for recurrent hepatocellular carcinoma and colorectal liver metastasis. However, the efficacy of a minimally invasive surgical approach for recurrent liver cancer is not yet confirmed. The purpose of this study is to examine the efficacy of minimally invasive repeat liver resection (MISRLR) compared with open repeat liver resection (ORLR) for primary and metastatic liver cancer. Here, we retrospectively analyzed the clinicopathological features and short-term surgical outcomes of patients undergoing MISRLR and ORLR. Methods: From 2005 to 2016, 97 patients with liver cancer underwent repeat hepatectomy. Of these patients, 68 patients receiving macroscopically curative resection and only hepatectomy, without other additional operations, were selected. Twenty patients underwent MISRLR and 48 patients underwent ORLR. We compared the clinicopathological and surgical parameters in the MISRLR group with those in the ORLR group. Results: There were no statistically significant differences in patients’ gender, age, viral infection status, Child–Pugh classification, tumor size, tumor number, tumor location, or the presence of liver cirrhosis in the two groups. The operative times were similar, but blood loss was significantly lower in MISRLR group (159 vs. 502 ml, P = 0.0035). The length of the postoperative hospital stay was significantly shorter in the MISRLR group (14.2 vs. 19.2 days, P = 0.0275). Postoperative complications were observed only in the ORLR group, with a complication rate of 19%. Conclusions: We demonstrate that MISRLR for primary and metastatic liver cancer reduces blood loss and postoperative complications compared with ORLR. MISRLR might be a feasible and effective procedure for the selected patients.

Original languageEnglish
Pages (from-to)46-52
Number of pages7
JournalSurgical endoscopy
Volume32
Issue number1
DOIs
Publication statusPublished - Jan 1 2018
Externally publishedYes

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Hepatectomy
Liver Neoplasms
Liver
Neoplasms
Virus Diseases
Operative Time
Liver Cirrhosis

All Science Journal Classification (ASJC) codes

  • Surgery

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Short-term surgical outcomes of minimally invasive repeat hepatectomy for recurrent liver cancer. / Noda, Takehiro; Eguchi, Hidetoshi; Wada, Hiroshi; Iwagami, Yoshifumi; Yamada, Daisaku; Asaoka, Tadafumi; Gotoh, Kunihito; Kawamoto, Koichi; Takeda, Yutaka; Tanemura, Masahiro; Umeshita, Koji; Doki, Yuichiro; Mori, Masaki.

In: Surgical endoscopy, Vol. 32, No. 1, 01.01.2018, p. 46-52.

Research output: Contribution to journalArticle

Noda, T, Eguchi, H, Wada, H, Iwagami, Y, Yamada, D, Asaoka, T, Gotoh, K, Kawamoto, K, Takeda, Y, Tanemura, M, Umeshita, K, Doki, Y & Mori, M 2018, 'Short-term surgical outcomes of minimally invasive repeat hepatectomy for recurrent liver cancer', Surgical endoscopy, vol. 32, no. 1, pp. 46-52. https://doi.org/10.1007/s00464-017-5632-8
Noda, Takehiro ; Eguchi, Hidetoshi ; Wada, Hiroshi ; Iwagami, Yoshifumi ; Yamada, Daisaku ; Asaoka, Tadafumi ; Gotoh, Kunihito ; Kawamoto, Koichi ; Takeda, Yutaka ; Tanemura, Masahiro ; Umeshita, Koji ; Doki, Yuichiro ; Mori, Masaki. / Short-term surgical outcomes of minimally invasive repeat hepatectomy for recurrent liver cancer. In: Surgical endoscopy. 2018 ; Vol. 32, No. 1. pp. 46-52.
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AU - Noda, Takehiro

AU - Eguchi, Hidetoshi

AU - Wada, Hiroshi

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AU - Yamada, Daisaku

AU - Asaoka, Tadafumi

AU - Gotoh, Kunihito

AU - Kawamoto, Koichi

AU - Takeda, Yutaka

AU - Tanemura, Masahiro

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AU - Doki, Yuichiro

AU - Mori, Masaki

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N2 - Background: Repeat liver resection is an effective treatment, with long-term surgical outcomes for recurrent hepatocellular carcinoma and colorectal liver metastasis. However, the efficacy of a minimally invasive surgical approach for recurrent liver cancer is not yet confirmed. The purpose of this study is to examine the efficacy of minimally invasive repeat liver resection (MISRLR) compared with open repeat liver resection (ORLR) for primary and metastatic liver cancer. Here, we retrospectively analyzed the clinicopathological features and short-term surgical outcomes of patients undergoing MISRLR and ORLR. Methods: From 2005 to 2016, 97 patients with liver cancer underwent repeat hepatectomy. Of these patients, 68 patients receiving macroscopically curative resection and only hepatectomy, without other additional operations, were selected. Twenty patients underwent MISRLR and 48 patients underwent ORLR. We compared the clinicopathological and surgical parameters in the MISRLR group with those in the ORLR group. Results: There were no statistically significant differences in patients’ gender, age, viral infection status, Child–Pugh classification, tumor size, tumor number, tumor location, or the presence of liver cirrhosis in the two groups. The operative times were similar, but blood loss was significantly lower in MISRLR group (159 vs. 502 ml, P = 0.0035). The length of the postoperative hospital stay was significantly shorter in the MISRLR group (14.2 vs. 19.2 days, P = 0.0275). Postoperative complications were observed only in the ORLR group, with a complication rate of 19%. Conclusions: We demonstrate that MISRLR for primary and metastatic liver cancer reduces blood loss and postoperative complications compared with ORLR. MISRLR might be a feasible and effective procedure for the selected patients.

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