Laparoscopic liver resection of hepatocellular carcinoma.
BACKGROUND
We have continued to develop laparoscopic hepatectomy as a means of surgical therapy for hepatocellular carcinoma (HCC).


METHODS
We evaluated the degree of invasiveness and analyzed the outcomes of laparoscopic hepatectomy compared with open hepatectomy for HCC.


RESULTS
There were notable differences with respect to blood loss and operating time compared with open hepatectomy cases. Patients started walking and eating significantly earlier in the laparoscopic hepatectomy group, and these more rapid recoveries allowed shorter hospitalizations. On the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, there was no difference in preoperative risk. However, a significant difference was seen in the surgical stress and comprehensive risk scores between the open hepatectomy and laparoscopic hepatectomy groups. Concerning the survival rate and disease-free survival rate, there were no significant differences between procedures.


CONCLUSIONS
Laparoscopic hepatectomy avoids some of the disadvantages of open hepatectomy and is beneficial for patient quality of life (QOL) as a minimally invasive procedure if the operative indications are appropriately based on preoperative liver function and the location and size of HCC.
Kaneko
Hironori
H
Department of Surgery, Omori Hospital, Toho University School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo 143-0015, Japan. hironori@med.toho-u.ac.jp
Takagi
Sumito
S
Otsuka
Yuichiro
Y
Tsuchiya
Masaru
M
Tamura
Akira
A
Katagiri
Toshio
T
Maeda
Tetsuya
T
Shiba
Tadaaki
T
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage; D011788:Quality of Life; D012189:Retrospective Studies; D016138:Walking