Abstract：
OBJECTIVE: Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) located in the posterosuperior segments (PS) have generally been considered more difficult than those for HCC in anterolateral segments (AL), but may be safe and feasible for selected patients with accumulated experience. In the present study, we investigated the effectiveness of LLR for single nodular HCCs ≤3 cm located in PS.
METHODS: In total, 473 patients who underwent partial liver resection for single nodular HCCs ≤3 cm at the 18 institutions belonging to the Kyusyu Study Group of Liver Surgery from January 2010 to December 2018 were enrolled. The short-term outcomes of laparoscopic partial liver resection and open liver resection (OLR) for HCCs ≤3 cm, with subgroup analysis of PS and AL, were compared using propensity score-matching analysis. Furthermore, results were also compared between LLR-PS and LLR-AL.
RESULTS: The original cohort of patients with HCC ≤3 cm included 328 patients with LLR and 145 with OLR. After matching, 140 patients with LLR and 140 with OLR were analyzed. Significant differences were found between groups in terms of volume of blood loss (median, 55 vs. 287 ml, p < 0.001), postoperative complications (0.71 vs. 8.57%, p = 0.003), and postoperative hospital stay (median, 9 vs. 14 days, p < 0.001). The results of subgroup analysis of PS were similar. Short-term outcomes did not differ significantly between LLR-PS and LLR-AL after matching.
CONCLUSIONS: Laparoscopic partial resection could be the preferred option for single nodular HCCs ≤3 cm located in PS.
METHODS: In total, 473 patients who underwent partial liver resection for single nodular HCCs ≤3 cm at the 18 institutions belonging to the Kyusyu Study Group of Liver Surgery from January 2010 to December 2018 were enrolled. The short-term outcomes of laparoscopic partial liver resection and open liver resection (OLR) for HCCs ≤3 cm, with subgroup analysis of PS and AL, were compared using propensity score-matching analysis. Furthermore, results were also compared between LLR-PS and LLR-AL.
RESULTS: The original cohort of patients with HCC ≤3 cm included 328 patients with LLR and 145 with OLR. After matching, 140 patients with LLR and 140 with OLR were analyzed. Significant differences were found between groups in terms of volume of blood loss (median, 55 vs. 287 ml, p < 0.001), postoperative complications (0.71 vs. 8.57%, p = 0.003), and postoperative hospital stay (median, 9 vs. 14 days, p < 0.001). The results of subgroup analysis of PS were similar. Short-term outcomes did not differ significantly between LLR-PS and LLR-AL after matching.
CONCLUSIONS: Laparoscopic partial resection could be the preferred option for single nodular HCCs ≤3 cm located in PS.
摘要：
目的：对于位于后上段（PS）的肝细胞癌（HCC），腹腔镜肝切除术（LLR）通常被认为比位于前外侧段（AL）的HCC更困难。但对于有积累经验的选定患者可能是安全可行的。在本研究中,我们研究了LLR对位于PS中≤3cm的单结节HCC的有效性。
方法：2010年1月至2018年12月，共有473例患者在Kyusyu肝脏外科研究组的18个机构中接受了≤3cm的单结节肝癌部分切除术。腹腔镜部分肝切除术和开腹肝切除术(OLR)对≤3cm肝癌的近期疗效,通过PS和AL的亚组分析，使用倾向得分匹配分析进行比较。此外，还比较了LLR-PS和LLR-AL的结果。
结果：HCC≤3cm患者的原始队列包括328名LLR患者和145名OLR患者。匹配后,分析140例LLR和140例OLR患者。两组之间在失血量方面存在显着差异（中位数，55对287毫升，P<0.001)，术后并发症(0.71vs8.57%,p=0.003),和术后住院时间(中位数，9vs14天，P<0.001)。PS的亚组分析结果相似。匹配后，LLR-PS和LLR-AL的短期结果没有显着差异。
结论：腹腔镜部分切除术可能是位于PS的单发结节≤3cm的肝癌患者的首选选择。本文受版权保护。保留所有权利。
方法：2010年1月至2018年12月，共有473例患者在Kyusyu肝脏外科研究组的18个机构中接受了≤3cm的单结节肝癌部分切除术。腹腔镜部分肝切除术和开腹肝切除术(OLR)对≤3cm肝癌的近期疗效,通过PS和AL的亚组分析，使用倾向得分匹配分析进行比较。此外，还比较了LLR-PS和LLR-AL的结果。
结果：HCC≤3cm患者的原始队列包括328名LLR患者和145名OLR患者。匹配后,分析140例LLR和140例OLR患者。两组之间在失血量方面存在显着差异（中位数，55对287毫升，P<0.001)，术后并发症(0.71vs8.57%,p=0.003),和术后住院时间(中位数，9vs14天，P<0.001)。PS的亚组分析结果相似。匹配后，LLR-PS和LLR-AL的短期结果没有显着差异。
结论：腹腔镜部分切除术可能是位于PS的单发结节≤3cm的肝癌患者的首选选择。本文受版权保护。保留所有权利。
