Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients.
BACKGROUND
We have used laparoscopic hepatectomy as a surgical treatment for HCC in patients with cirrhosis. We describe the indications, evaluate invasiveness and analyze the outcomes of laparoscopic hepatectomy.


RESULTS
With respect to operative method, laparoscopic hepatectomy involving either partial hepatectomy or left lateral sectionectomy is a less invasive procedure in patients with cirrhosis than conventional hepatectomy. Among our laparoscopic hepatectomy cases, operative time was shorter and bleeding was less in recent, as compared to earlier, cases. Furthermore, laparoscopic hepatectomy was less invasive than conventional hepatectomy, as determined by the E-PASS scoring system. Patients also recovered more quickly, which resulted in shorter hospital stays even for patients with cirrhosis. Both the 5-year survival rate and the rate of survival without recurrence of HCC were nearly identical to those of open conventional hepatectomy.


CONCLUSIONS
These findings indicate that laparoscopic hepatectomy avoids the disadvantages of standard hepatectomy for HCC in properly selected patients with cirrhosis and that its minimal invasiveness improves patients' quality of life.
Kaneko
Hironori
H
Department of Surgery (Omori), Toho University School of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-0015, Japan. hironori@med.toho-u.ac.jp
Tsuchiya
Masaru
M
Otsuka
Yuichiro
Y
Yajima
Satoshi
S
Minagawa
Teruaki
T
Watanabe
Masashi
M
Tamura
Akira
A
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000150:complications / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D011788:Quality of Life