Laparoscopic limited anatomical hepatectomy for hepatocellular carcinoma within the right anterior section: a propensity score matched study
10.3760/cma.j.cn113884-20230808-00027
- VernacularTitle:腹腔镜限量解剖性肝切除术治疗右前区肝细胞癌的倾向性评分匹配研究
- Author:
Yuewen KUANG
1
;
Xuesong LI
;
Jianwei LI
;
Xiaojun WANG
;
Feng TIAN
;
Li CAO
;
Renjie LI
;
Kexi LIAO
;
Bowen ZHENG
;
Yue WANG
;
Shuguo ZHENG
Author Information
1. 陆军军医大学第一附属医院肝胆外科，重庆 400038
- Keywords:
Carcinoma, hepatocellular;
Laparoscope;
Anatomical liver resection
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(11):826-831
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the efficacy of laparoscopic limited anatomical hepatectomy (LLAH) for hepatocellular carcinoma (HCC) within the right anterior section.Methods:The clinical data of 144 patients with HCC confined in the right anterior section undergoing hepatectomy at the First Affiliated Hospital of Army Medical University from January 2015 to December 2022 were retrospectively analyzed, including 122 males and 22 females, aged (54.5±9.7) years. Patients were divided into LLAH ( n=27), laparoscopic anatomical hepatectomy (LAH, n=69), and laparoscopic non-anatomical hepatectomy (LNAH, n=48). Propensity score matching was used to compare the operative time, postoperative hospital stay, postoperative complications, serum total bilirubin and albumin, and the prognostic indicators such as tumor-free survival (DFS) rate and cumulative survival rate between the groups. Results:After propensity score matching, there were 26 cases each in LLAH and LNAH group. There was no significant difference in operative time, intraoperative blood loss and postoperative hospital stay between LLAH group and LNAH group (all P<0.05). The total bilirubin and albumin in LLAH on the third day after operation were [ M( Q1, Q3)] 24.1(20.9, 29.1) μmol/L and (35.8±2.9) g/L, better than those in LNAH group 39.3(33.2, 57.0) μmol/L and (33.9±2.5) g/L, respectively. The 1- and 3-year DFS rates in LLAH group were 92.3% and 57.7%, higher than those in LNAH group (80.8% and 19.2%) (all P<0.05). After propensity score matching, there were 25 patients each in LLAH and LAH group. The operative time, postoperative hospital stay and postoperative complications of LLAH group were lower than those of LAH group, and the liver function parameters of LLAH group was also better than those of LAH group (all P<0.05). There was no significant difference in DSF rate between the two groups LLAH group and LAH group ( χ2=0.10, P=0.800). Conclusions:The perioperative outcome of LLAH for HCC within the right anterior section are similar to that of LNAH and better than that of LAH. The DFS of LLAH were better than that of LNAH and similar to that of LAH.
