Which approach is preferred in left hepatocellular carcinoma? Laparoscopic versus open hepatectomy using propensity score matching.
Which approach is preferred in left hepatocellular carcinoma? Laparoscopic versus open hepatectomy using propensity score matching.
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DOI：
10.1186/s12885-018-4506-3
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发表时间：
2018-06-19
期刊：
影响因子：
3.8
通讯作者：
Joh JW
中科院分区：
文献类型：
--
作者：
Kim JM;Kwon CHD;Yoo H;Kim KS;Lee J;Kim K;Choi GS;Joh JW
腹腔镜肝切除术是治疗肝细胞癌（HCC）的一种安全有效的方法。然而，其围手术期和肿瘤学的结果还没有在左肝切除术患者进行评估。本研究的目的是比较通过腹腔镜和开放性方法进行左肝切除术治疗左肝肝癌的结果。2012年12月至2016年10月，40例患者行腹腔镜左肝切除术（LLH），80例患者行开放式左肝切除术（OLH）。对所有临床资料进行回顾性分析。基于肿瘤大小和微血管浸润的存在，以1：1的比例进行患者的倾向评分匹配。OLH组的肿瘤大小和微血管浸润均高于LLH组（P < 0.05）。然而，LLH组的手术时间长于OLH组（266 min vs. 239 min; P = 0.005）。匹配前后，LLH组的中位术后住院时间明显短于OLH组（9天vs. 13天; P < 0.001）。LLH和OLH组的并发症发生率分别为10.0%和7.5%。倾向评分匹配后，LLH组的无病生存期（DFS）和总生存期（OS）与OLH组无差异。腹腔镜方法是可行的和安全的左肝细胞癌。LLH的肿瘤学结局与OLH相当。
Laparoscopic liver resection has been reported as a safe and effective approach for the management of hepatocellular carcinoma (HCC). However, its perioperative and oncological outcomes have not been evaluated in left hepatectomy patients. The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC. From December 2012 to October 2016, laparoscopic left hepatectomy (LLH) was performed in 40 patients and open left hepatectomy (OLH) was performed in 80 patients. All clinical data were analyzed retrospectively. Propensity score matching of patients in a 1:1 ratio was conducted based on tumor size and presence of microvascular invasion. Tumor size and presence of microvascular invasion were higher in the OLH group than the LLH group (P < 0.05). However, the operative time was longer in the LLH group than in the OLH group (266 min vs. 239 min; P = 0.005). The median postoperative hospital stay was significantly shorter in the LLH group than in the OLH group before and after matching (9 days vs. 13 days; P < 0.001). The incidence of complications in the LLH and OLH groups was 10.0 and 7.5%, respectively. The disease-free survival (DFS) and overall survival (OS) in the LLH group were not different from those in the OLH group after propensity score matching. A laparoscopic approach is feasible and safe for left HCC. The oncologic outcome of LLH is comparable to that of OLH.
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作者：
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