Liver resection for hepatocellular carcinoma: case-matched analysis of laparoscopic versus open resection
김호현, 박은규, 성진식, 허영회, 고양석, 김정철, 조철균, 김현종,
소속 상세정보
김호현 ( Kim Ho-Hyun )
Chonnam National University Medical School Department of Surgery
박은규 ( Park Eun-Kyu )
Chonnam National University Medical School Department of Surgery
성진식 ( Seoung Jin-Shick )
Chonnam National University Medical School Department of Surgery
허영회 ( Hur Young-Hoe )
Chonnam National University Medical School Department of Surgery
고양석 ( Koh Yang-Seok )
Chonnam National University Medical School Department of Surgery
김정철 ( Kim Jung-Chul )
Chonnam National University Medical School Department of Surgery
조철균 ( Cho Chol-Kyoon )
Chonnam National University Medical School Department of Surgery
김현종 ( Kim Hyun-Jong )
Chonnam National University Medical School Department of Surgery
KMID : 0371320110800060412
Abstract
Purpose: To analyze the outcomes of laparoscopic liver resection compared with open liver resection in patients with hepatocellular carcinoma (HCC).
Methods: Between July 2005 and December 2009, 26 consecutive patients with HCC underwent a pure laparoscopic liver resection, and data from this group (laparoscopic liver resection group, L-group) were compared with a retrospective control group of 29 patients who underwent open liver resection for HCC (open liver resection group, O-group) during the same period. The two groups were matched in terms of demographic data, tumor size, degree of liver cirrhosis, American Society of Anesthesiology score, type of resection, and tumor location.
Results: Median operation time and the amount of intraoperative packed red blood cell transfusion in the L-group were 147.5 minutes and 0.35 units, respectively. The L-group revealed a shorter operation time (147.5 vs. 220.0 minutes, P = 0.031) than the O-group. No difference in perioperative morbidity or mortality rates was observed (3.8, 0 vs. 24.1%, 0%; P = 0.054, non-specific, respectively); the L-group was associated with a shorter hospital stay than the O-group (11.08 vs. 16.07 days, P = 0.034). After a mean follow-up of 23.9 months (range, 0.7 to 59.4 months), the 1-year disease-free survival rate was 84.6% in the L-group and 82.8% in the O-group (P = 0.673).
Conclusion: Laparoscopic liver resection for HCC is feasible and safe in selected patients and can produce good surgical results with a shorter postoperative hospital stay and similar outcomes in terms of perioperative morbidity, mortality, and disease-free survival than open resection.
키워드
Laparoscopic surgery; Open surgery; Hepatocellular carcinoma; Resection
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