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. 2023 Feb 13;35(3):247-252.
doi: 10.4103/tcmj.tcmj_293_22. eCollection 2023 Jul-Sep.

Previous nonhepatectomy abdominal surgery did not increase the difficulty in laparoscopic hepatectomy for hepatocellular carcinoma: A case-control study in 100 consecutive patients

Yi-Hsuan Lee  1 , Hsiu-Hsien Lin  1 , Tsai-Ling Kuo  1   2 , Ming-Che Lee  3   4 , Yen-Cheng Chen  1   5
Affiliations

Previous nonhepatectomy abdominal surgery did not increase the difficulty in laparoscopic hepatectomy for hepatocellular carcinoma: A case-control study in 100 consecutive patients

Yi-Hsuan Lee et al. Tzu Chi Med J. .

Abstract

Objectives: Laparoscopic hepatectomy (LH) is still technically challenging for patients with previous nonhepatectomy abdominal surgery (AS). Therefore, this study aimed to assess the difficulty of performing LH for patients with hepatocellular carcinoma (HCC) and a history of nonhepatectomy AS during the initial developing period of LH.

Materials and methods: The retrospective study enrolled patients who were newly diagnosed with HCC receiving LH from January 2013 to June 2021. Demographic characteristics, perioperative variables, and surgical complications were prospectively collected.

Results: One hundred patients were reviewed consecutively, comprising 23 in the AS group and 77 in the non-AS group. No significant differences were observed in median IWATE score (5 vs. 5, P = 0.194), operative time (219 vs. 200 min, P = 0.609), blood loss (100.0 vs. 200.0 mL, P = 0.734), transfusion rate (4.3% vs. 10.4%, P = 0.374), duration of parenchyma transection (90.0 vs. 72.4 min, P = 0.673), and mean nonparenchymal transection time (191.0 vs. 125.0 min, P = 0.228), without increasing the conversion rate (0.0% vs. 3.9%, P = 0.336), postoperative complications (30.3% vs. 33.8%, P = 0.488), and postoperative hospital stay (6 vs. 7 days, P = 0.060) in AS group and non-AS groups.

Conclusion: History of previous nonhepatectomy AS can lead to longer nonparenchymal transection time instead of conversion and did not increase the difficulty. Prolonged nonparenchymal transection time did not increase the surgical complications, prolong the postoperative hospital stay, and compromise the survival outcomes.

Keywords: Abdomen/surgery; hepatectomy; laparoscopy; operative time; outcome.

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Conflict of interest statement

Dr. Ming-Che Lee, an editorial board member at Tzu Chi Medical Journal, had no role in the peer review process of or decision to publish this article. The other authors declared no conflicts of interest in writing this paper.

Figures

Figure 1
Figure 1
The Kaplan–Meier curve of overall survival in the AS and non-AS groups. The 12-and 24-month overall survival rates were 89.8% and 82.4% in the AS group and 88.4% and 85.9% in the non-AS group. Log-rank test, P = 0.820. AS: Abdominal surgery, non-AS: Nonabdominal surgery
Figure 2
Figure 2
The Kaplan–Meier curve of disease-free survival in the AS and non-AS groups. The 12-and 24-month disease-free survival rates were 81.0% and 65.8% in the AS group and 64.8% and 56.8% in the non-AS group. Log-rank test, P = 0.155. AS: Abdominal surgery, non-AS: Nonabdominal surgery
See this image and copyright information in PMC

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