Laparoscopic repeat liver resection for recurrent hepatocellular carcinoma.
BACKGROUND
Repeat liver resection is effective for recurrent hepatocellular carcinoma (rHCC). This study aimed to determine the outcomes of laparoscopic repeat liver resection (LRLR) for rHCC.


METHODS
Eight consecutive patients who underwent LRLR for rHCC were retrospectively reviewed.


RESULTS
Six patients had previous open and two had laparoscopic liver resection (LLR). There was one (12.5%) open conversion for bleeding and one (12.5%) post-operative morbidity. The median tumour size was 24 mm (range: 8-50 mm). LRLR was performed for rHCC in the ipsilateral lobe as compared to the index surgery in 4/8 (50%) patients. Five of eight (62.5%) patients had rHCC in the difficult posterosuperior segments. Six patients had previous open LR, and two had previous LLR. One patient (patient 4) had two prior open LR for rHCC, and LRLR was performed for the second recurrence. The median duration from the first surgery to LRLR was 29 months (range: 6-109 months). The median post-operative stay was 3.5 days. All eight patients had R0 resections, and at a median follow-up of 7.5 months, all patients were disease-free.


CONCLUSIONS
LRLR for rHCC is feasible and safe. This can be performed even for patients with previous open liver resections, cirrhosis, lesions in the posterosuperior segments and prior LR of the ipsilateral lobe. LRLR for rHCC is feasible and safe in highly selected patients.
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-National University of Singapore Medical School, Singapore.
Brian K P
BKP
Goh
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
Jin-Yao
JY
Teo
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
Chung-Yip
CY
Chan
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
Ser-Yee
SY
Lee
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
Peng-Chung
PC
Cheow
Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
Alexander Y F
AYF
Chung
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008099:Liver / Q000473:pathology / Q000601:surgery; D008103:Liver Cirrhosis / Q000601:surgery; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000401:mortality; D011446:Prospective Studies; D012086:Reoperation / Q000379:methods* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016896:Treatment Outcome
laparoscopic hepatectomy; laparoscopic liver resection; laparoscopy; recurrent hepatocellular carcinoma; repeat hepatectomy; repeat liver resection