Laparoscopy of hepatocellular carcinoma is helpful in minimizing intra-abdominal adhesion during salvage transplantation.
10.4174/astr.2018.95.5.258
- Author:
Jinsoo RHU
1
;
Jong Man KIM
;
Gyu Seong CHOI
;
Choon Hyuck David KWON
;
Jae Won JOH
;
Olivier SOUBRANE
Author Information
1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yjongman21@gmail.com
- Publication Type:Original Article
- Keywords:
H epatocellular carcinoma;
Laparoscopy;
Liver transplantation;
Surgical adhesion
- MeSH:
Carcinoma, Hepatocellular*;
Humans;
Laparoscopy*;
Liver;
Liver Transplantation;
Logistic Models;
Prospective Studies;
Surgeons;
Tissue Adhesions
- From:Annals of Surgical Treatment and Research
2018;95(5):258-266
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: This study analyzes the impact of laparoscopic liver resection on intra-abdominal adhesion. METHODS: Patients who underwent salvage liver transplantation after liver resection for hepatocellular carcinoma from January 2012 to October 2017 at our institution were included. Information about the severity of intra-abdominal adhesions was collected from a prospectively maintained database. Intra-abdominal adhesions were graded after the agreement of 2 surgeons who participated in the salvage liver transplantation based on predetermined criteria. Adhesion severity and demographic, operative, and postoperative data were compared between the laparoscopic group and the open group. Multivariate logistic regression was performed to consider potential factors related to severe adhesion during salvage transplantation. RESULTS: Sixty-two patients who underwent salvage liver transplantation after liver resection were included in this study. Among them, 52 patients underwent open surgery, and 10 patients underwent laparoscopy. Adhesion was significantly more severe in the open group than in the laparoscopy group (P = 0.029). A multivariate logistic regression model including potential factors related to severe adhesion showed that laparoscopy (odds ratio, 0.168; 95% confidence interval, 0.029–0.970; P = 0.048) was the only significant factor. CONCLUSION: Laparoscopic liver resection for hepatocellular carcinoma can minimize intra-abdominal adhesion during salvage liver transplantation.
