Laparoscopic repeat liver resection for hepatocellular carcinoma: a multicentre propensity score-based study

作者：Zenichi Morise, Luca Antonio Aldrighetti, Giulio Belli, Francesca Ratti, Andrea Belli, Daniel Cherqui, Minoru Tanabe, Go Wakabayashi, T T Cheung, Chung Mau Lo, Shogo Tanaka, Shoji Kubo, Yukiyasu Okamura, Katsuhiko Uesaka, Kazuteru Monden, Hiroshi Sadamori, Keisuke Hashida, Kenichiro Kawamoto, Naoto Gotohda, K H Chen, Akishige Kanazawa, Yutaka Takeda, Yoshiaki Ohmura, Masaki Ueno, Toshiro Ogura, Kyung‐Suk Suh, Yutaro Kato, Atsushi Sugioka, Hiroyuki Nitta, Masafumi Yasunaga, N A Halium, Alexis Laurent, H Kaneko, Yuichiro Otsuka, Ki Hyun Kim, H Cho, Charles Lin, Yusuke Ome, Yasuji Seyama, Roberto Ivan TROISI, Giammauro Berardi, F Roteller, G C Wilson, David A. Geller, Olivier Soubrane, Tomoaki Yoh, Takashi Kaizu, Yusuke Kumamoto, HS Han, Ela Ekmekcigil, Ibrahim K. Dagher, David Fuks, Brice Gayet, Joseph F. Buell, Rubén Ciria, Juan C. Briceño, Nicholas O’Rourke, Joel Lewin, Bjørn Edwin, Masahiro Shinoda, Yuta Abe, Mohammad Abu Hilal, Mohammad Nasri Alzoubi · 发表于：British journal of surgery · 年份：2020 · DOI：10.1002/bjs.11436 · 被引用次数：87 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment、Multiple and Secondary Primary Cancers

BACKGROUND: In the absence of randomized controlled data and even propensity-matched data, indications for, and outcomes of, laparoscopic repeat liver resection for hepatocellular carcinoma (HCC) remain uncertain. This study aimed to clarify the current indications for laparoscopic repeat liver resection for HCC, and to evaluate outcomes. METHODS: Forty-two liver surgery centres around the world registered patients who underwent repeat liver resection for HCC. Patient characteristics, preoperative liver function, tumour characteristics, surgical method, and short- and long-term outcomes were recorded. RESULTS: Analyses showed that the laparoscopic procedure was generally used in patients with relatively poor performance status and liver function, but favourable tumour characteristics. Intraoperative blood loss (mean(s.d.) 254(551) versus 748(1128) ml; P < 0·001), duration of operation (248(156) versus 285(167) min; P < 0·001), morbidity (12·7 versus 18·1 per cent; P = 0·006) and duration of postoperative hospital stay (10·1(14·3) versus 11·8(11·8) days; P = 0·013) were significantly reduced for laparoscopic compared with open procedures, whereas survival time was comparable (median 10·04 versus 8·94 years; P = 0·297). Propensity score matching showed that laparoscopic repeat liver resection for HCC resulted in less intraoperative blood loss (268(730) versus 497(784) ml; P = 0·001) and a longer operation time (272(187) versus 232(129); P = 0·007) than the open approach, and si...