364663

Minimally invasive vs traditional liver resection in managing small hepatocellular carcinoma

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Last updated: 05 Jan 2025

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Abstract

Background
Laparoscopic liver resection (LLR) has been progressively developed along the past two decades. Surgical technique and equipment have been evolved to overcome technical limitations, making LLR safe and feasible. Surgeons develop skills in a stepwise approach, beginning with low complexity operations for benign diseases and reaching high-complexity surgeries for malignant cases and living donor organ harvesting.
Patients and methods
In this prospective randomized study, a comparison between laparoscopic and open resection was done to compare short-term results regarding intraoperative details, postoperative management, and complications. This study was conducted on 30 patients with hepatocellular carcinoma (HCC): 15 (50%) patients were treated by LLR (group A), whereas the other 15 (50%) patients were treated by open liver resection (group B).
Results
Regarding the demographic data, the presence of past history of medical condition, and the preoperative laboratory results, no statistically significant difference was found. The mean operative time has a statistically significant difference between the two groups, with decreased operative time in the laparoscopic group (<0.001). Postoperative follow-up showed that the most frequent complication was postoperative ascites, which was seen in 12 (80%) cases in the open group and in six (40%) cases in laparoscopic group, with highly significant difference between both groups. Recurrence occurred in one patient in the LLR group and no cases in the other group.
Conclusion
LLR is a safe and feasible treatment option for HCC in cirrhotic patient needing minor resection at laparoscopic liver segments II, III, IVa, V, and VI. LLR for HCC has superior short-term and comparable oncological outcomes to open liver resection. LLR should be performed for carefully selected patients and by an expert surgical team.

DOI

10.4103/ejs.ejs_122_20

Keywords

anatomical resection, Cirrhotic Patients, Hepatocellular carcinoma

Authors

First Name

Hatem S.

Last Name

Saber

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Affiliation

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Orcid

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First Name

Ahmed A.

Last Name

Abdelshafy

MiddleName

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Affiliation

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Email

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Orcid

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First Name

Mohammed A.

Last Name

Hamed

MiddleName

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Affiliation

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Email

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Orcid

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Volume

39

Article Issue

4

Related Issue

48959

Issue Date

2020-12-01

Receive Date

2020-05-01

Publish Date

2020-12-24

Print ISSN

1110-1121

Online ISSN

1687-7624

Link

https://ejsur.journals.ekb.eg/article_364663.html

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https://ejsur.journals.ekb.eg/service?article_code=364663

Order

364,663

Publication Type

Journal

Publication Title

The Egyptian Journal of Surgery

Publication Link

https://ejsur.journals.ekb.eg/

MainTitle

Minimally invasive vs traditional liver resection in managing small hepatocellular carcinoma

Details

Type

Article

Created At

21 Dec 2024