Indications of Laparoscopic Repeat Liver Resection for Recurrent Hepatocellular Carcinoma
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- Masahiko Kinoshita
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Akishige Kanazawa
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City General Hospital Osaka Japan
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- Shogo Tanaka
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Shigekazu Takemura
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Ryosuke Amano
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Kenjiro Kimura
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Hiroji Shinkawa
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Go Ohira
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Kohei Nishio
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
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- Shoji Kubo
- Department of Hepato‐Biliary‐Pancreatic Surgery Osaka City University Graduate School of Medicine Osaka Japan
抄録
<jats:title>Abstract</jats:title><jats:sec><jats:title>Aim</jats:title><jats:p>This study aimed to evaluate the indications of laparoscopic repeat liver resection (LRLR) for recurrent hepatocellular carcinoma from the viewpoint of its difficulty.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>One hundred and one patients who underwent LRLR and 59 patients who underwent open repeat liver resection (ORLR) were included. The difficulty was classified according to the preoperative predictive factors for difficult LRLR, including an open approach during previous liver resection, history of two or more previous liver resections, history of previous major liver resection, tumor near the resected site of the previous liver resection, and intermediate or high difficulty with the difficulty scoring system. We compared the surgical outcomes between the LRLR and ORLR groups based on the difficulty class (low‐ or intermediate difficiulty class, 0 to 3 predictive factors; high difficiulty class, 4 or 5 factors).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In the low‐ or intermediate difficiulty class, intraoperative blood loss and the proportion of patients with postoperative complications were significantly lower in LRLR than in ORLR, and the duration of the postoperative hospital stay was significantly shorter in LRLR than in ORLR. In the high difficiulty class, total operative time and operative time before starting hepatic parenchymal resection were significantly longer in LRLR than in ORLR, and there were no significant differences in other surgical outcomes between the two groups.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>LRLR is recommended for patients in the low or intermediate difficulty class. However, LRLR does not have an advantage with longer operative time for patients in the high difficulty class compared with ORLR.</jats:p></jats:sec>
収録刊行物
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- Annals of Gastroenterological Surgery
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Annals of Gastroenterological Surgery 6 (1), 119-126, 2021-08-04
Wiley