Feasibility and efficacy of repeat laparoscopic liver resection for recurrent hepatocellular carcinoma
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and Other Interventional Techniques
Feasibility and efficacy of repeat laparoscopic liver resection for recurrent hepatocellular carcinoma Takashi Onoe1,2 · Megumi Yamaguchi1 · Toshimitsu Irei1 · Kohei Ishiyama1 · Takeshi Sudo1 · Naoto Hadano1 · Masato Kojima1 · Haruna Kubota1 · Ryuta Ide1 · Hirofumi Tazawa1 · Wataru Shimizu1 · Takahisa Suzuki1 · Yosuke Shimizu1 · Takao Hinoi1 · Hirotaka Tashiro1,2 Received: 6 March 2019 / Accepted: 31 October 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Repeat hepatectomy is an acceptable treatment for recurrent hepatocellular carcinoma (HCC). However, repeat laparoscopic liver resection (LLR) has not been widely adopted due to its technical difficulty. This study aimed to assess the feasibility and efficacy of repeat LLR compared with repeat open liver resection (OLR) for recurrent HCC. Methods We performed 42 repeat OLR and 30 repeat LLR for cases of recurrent HCC between January 2007 and March 2018. This study retrospectively compared the patients’ clinicopathological characteristics and operative and short-term outcomes including surgical time, intraoperative blood loss, duration of hospital stay, and postoperative complications between the two groups. Results There were no significant differences in patient characteristics between the two groups except in terms of Child– Pugh grade. The repeat LLR group had lower median intraoperative blood loss (100 mL vs. 435 mL; P = 0.001) and shorter median postoperative hospital stay (10 days vs. 14.5 days; P = 0.002). The other results including postoperative complications were comparable between the two groups. Further, comparison of two subpopulations of the repeat LLR group stratified by previous hepatectomy type (open or laparoscopic) or tumor location (segments 7 and 8 or other) revealed no significant differences in the postoperative clinical characteristics between them, although the morbidity rate tended to be higher in patients who underwent open hepatectomy for primary HCC than in patients who underwent laparoscopic hepatectomy. Conclusions Repeat LLR for recurrent HCC is feasible and useful with good short-term outcomes although an appropriate patient selection seems to be necessary. Keywords Laparoscopic liver resection · Repeat surgery · Hepatocellular carcinoma Liver resection is well established as the most effective therapy for both hepatocellular carcinoma (HCC) and cholangiocellular carcinoma (CCC). Nevertheless, the intrahepatic recurrence rate after liver resection remains high. Thus, * Takashi Onoe [email protected] * Hirotaka Tashiro [email protected] 1
Department of Surgery, Kure Medical Center/Chugoku Cancer Center, 3‑1 Aoyama, Kure, Hiroshima 737‑0023, Japan
Department of Gastroenterological and Transplant Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1‑2‑3 Kasumi, Minami‑ku, Hiroshima 734‑8551, Japan
2
repeat liver resection has been accepted as an effective therapeutic strategy for intrahepatic r
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