Laparoscopic versus open liver resection for tumours originating in the paracaval portion of caudate lobe

• Main Authors: SUN Tiange, WANG Xiaojun, CAO Li, LI Jianwei, CHEN Jian, LI Xuesong, LIAO Kexi, ZHENG Shuguo
• Format: Article
• Language: zho
• Published: Editorial Office of Journal of Third Military Medical University 2021-04-01
• Series: Di-san junyi daxue xuebao
• Subjects: laparoscopy; hepatectomy; paracaval portion; liver neoplasms
• Online Access: https://aammt.tmmu.edu.cn/Upload/rhtml/202012027.htm

Objective To compare the perioperative outcomes and long-term efficacy of laparoscopic liver resection (LLR) and open liver resection (OLR) for hepatocellular carcinoma originating in the paracaval portion, and explore the safety and feasibility of LLR in treatment of paracaval-originating tumors. Methods Forty-two paracaval-originating tumor patients admitted in our hospital from May 2013 to May 2020 were enrolled in this study. The median follow-up time of the patients was 27.5 months in the LLR group and 26.0 months in the OLR group. Perioperative outcomes and long-term effect were analyzed retrospectively. Results There were 21 patients undergoing LLR and the other 21 OLR, and no perioperative death occurred. One case of the LLR group was converted to OLR during operation. There were no significant differences in operation time, blood loss, intraoperative transfusion rate, resection margin of malignant tumour or postoperative complications. The LLR group obtained earlier postoperative feeding (P=0.042), shorter length of hospital stay (P=0.008), and lower postoperative total bilirubin at 1, 3 and 7 d after surgery (P=0.004, 0.010, 0.018) when compared with the OLR group. What's more, no obviously differences were seen in 1- and 3-year overall survival rates (100.0% vs 87.5%, P=0.292; 87.5% vs 68.8%, P=0.326) or in 1- and 3-year disease-free survival rates (62.5% vs 50.0%, P=0.488; 50.0% vs 37.5%, P=0.455) between the 2 groups. Conclusion LLR is safe and feasible for paracaval-originating tumours in selected patients, with the advantages of earlier postoperative feeding and shorter hospital stay.