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. 2018 Jun 19;18(1):668.
doi: 10.1186/s12885-018-4506-3.

Which approach is preferred in left hepatocellular carcinoma? Laparoscopic versus open hepatectomy using propensity score matching

Jong Man Kim  1 , Choon Hyuck David Kwon  1 , Heejin Yoo  2 , Kyeung-Sik Kim  1 , Jisoo Lee  1 , Kyunga Kim  2 , Gyu-Seong Choi  1 , Jae-Won Joh  3
Affiliations

Which approach is preferred in left hepatocellular carcinoma? Laparoscopic versus open hepatectomy using propensity score matching

Jong Man Kim et al. BMC Cancer. .

Abstract

Background: Laparoscopic liver resection has been reported as a safe and effective approach for the management of hepatocellular carcinoma (HCC). However, its perioperative and oncological outcomes have not been evaluated in left hepatectomy patients. The aim of the present study is to compare the outcomes of left hepatectomy through laparoscopic and open approaches in left HCC.

Methods: From December 2012 to October 2016, laparoscopic left hepatectomy (LLH) was performed in 40 patients and open left hepatectomy (OLH) was performed in 80 patients. All clinical data were analyzed retrospectively. Propensity score matching of patients in a 1:1 ratio was conducted based on tumor size and presence of microvascular invasion.

Results: Tumor size and presence of microvascular invasion were higher in the OLH group than the LLH group (P < 0.05). However, the operative time was longer in the LLH group than in the OLH group (266 min vs. 239 min; P = 0.005). The median postoperative hospital stay was significantly shorter in the LLH group than in the OLH group before and after matching (9 days vs. 13 days; P < 0.001). The incidence of complications in the LLH and OLH groups was 10.0 and 7.5%, respectively. The disease-free survival (DFS) and overall survival (OS) in the LLH group were not different from those in the OLH group after propensity score matching.

Conclusions: A laparoscopic approach is feasible and safe for left HCC. The oncologic outcome of LLH is comparable to that of OLH.

Keywords: Hepatectomy; Hepatocellular carcinoma; Laparoscopy; Minimal invasive surgery; Survival; Tumor recurrence.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Samsung Medical Center Institutional Review Board (IRB) (SMC-2017-05-090). The consent of the participant was exempted through IRB.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a Disease-free survival and b patient survival before propensity score matching
Fig. 2
Fig. 2
a Disease-free survival and b patient survival after propensity score matching
See this image and copyright information in PMC

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