title: Impact of previous hepatectomy on short-term outcomes of repeat hepatectomy for liver tumors with a special concern of operative time.
abstract: OBJECTIVE
  Repeat hepatectomy is widely accepted as a treatment for primary or metastatic liver malignancy. However, it entails a longer operative time and is associated with additional operative risks. The goal of the present study was to evaluate the impact of previous hepatectomy on the short-term outcomes of repeat hepatectomy, especially in operative time.
  
  
  METHODS
  A retrospective review of prospectively collected data from patients who underwent primary hepatectomy (n=166) and repeat hepatectomy (n=65) in a single institution.
  
  
  RESULTS
  Operative time was significantly longer for repeat hepatectomy than for primary hepatectomy (284min vs. 250min, p=0.04). There were no significant differences between the two groups with respect to intraoperative blood loss, intraoperative blood transfusion, morbidity, mortality and length of hospital stay. Multivariate analysis demonstrated that third or subsequent hepatectomy and tumor location in the caudate lobe at the repeat hepatectomy significantly prolonged operative time.
  
  
  CONCLUSIONS
  Repeat hepatectomy has similar short-term outcomes to primary liver resection. However, repeat hepatectomy is a time-consuming operation, especially in patients with tumors in the caudate lobe or for those undergoing their third or subsequent hepatectomy.
authors.affiliation: Department of Gastrointestinal Surgery, Japanese Foundation for Cancer Research, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Morimura
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.forename: Rintaro
authors.initials: R
authors.lastname: Koga
authors.forename: Masaaki
authors.initials: M
authors.lastname: Matsumura
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Seki
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Ryuji
authors.initials: R
authors.lastname: Yoshioka
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Yamaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome