Laparoscopic versus open mesohepatectomy for patients with centrally located hepatocellular carcinoma: a propensity score matched analysis

Li, Wei; Han, Jun; Xie, Gongnan; Xiao, Yang; Sun, Kai; Yuan, Kefei; Wu, Hong

doi:10.1007/s00464-018-6593-2

Cited by 16 publications

(31 citation statements)

References 50 publications

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“…reported on significantly longer operative times, there was no significant difference found in reports by Jeung et al . and Li et al 7,15–17 . Importantly, the longer operative times in studies by Kim et al .…”

Section: Discussionmentioning

confidence: 95%

“…The technical difficulty associated with CH and RAS arises from the unique challenge of having to resect two large transection planes, combined with the frequent proximity of CLT to major vessels and the high risk of encountering uncontrollable bleeding 16,45 . Nonetheless, several recent studies have reported the feasibility and safety of MILR for CH and RAS in selected patient populations 7,15–17 . To date, there have been only three PSM studies comparing MILR versus OLR for CLT, all of which have demonstrated the superiority of MILR in terms of peri‐operative outcomes 15–17 .…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, several recent studies have reported the feasibility and safety of MILR for CH and RAS in selected patient populations 7,15–17 . To date, there have been only three PSM studies comparing MILR versus OLR for CLT, all of which have demonstrated the superiority of MILR in terms of peri‐operative outcomes 15–17 . In addition, Jeung et al .…”

Section: Discussionmentioning

confidence: 99%

“…Our study is, to date, the second‐largest PSM analysis comparing MILR versus OLR in patients with CLT 7,15–17 . PSM studies have the benefit of mitigating confounding bias and explicitly addressing selection bias by matching patients based on their conditional probability of being selected to undergo either intervention regime.…”

Section: Discussionmentioning

confidence: 99%

“…Since the first official documented report of a successful laparoscopic CH in 2009, there have been several retrospective studies documenting both the feasibility and potential advantages of MILR for CLT 7,14–17 . To date, only three propensity score‐matched (PSM) studies have been published, including two single‐institution reviews from Korea (18 and 20 patients in MILR arm) and one from China (40 patients in MILR arm) 15–17 …”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Chin

Linn

Cheong

et al. 2021

ANZ Journal of Surgery

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Background The utility of minimally‐invasive liver resection (MILR) for deep centrally located tumours (CLT) remains controversial. We aimed to review our institution's experience and outcomes with minimally invasive central hepatectomy (CH) and right anterior sectionectomy (RAS) for CLT in a propensity score‐matched (PSM) analysis. Methods Retrospective review of a prospectively maintained surgical database revealed 23 patients who underwent MILR (6 CH, 17 RAS) and 53 patients who underwent open liver resection (OLR; 24 CH, 29 RAS) for CLT. PSM in a 1:1 ratio identified two groups of patients with similar baseline clinicopathological characteristics. Peri‐operative outcomes were then compared. Results There was one laparoscopic‐assisted, one robot‐assisted and two laparoscopic‐converted‐open procedures in the MILR cohort. Across the unmatched cohort, there was only one mortality (MILR) and five patients with major morbidity (all OLR). MILR was associated with a longer operating time (P < 0.001), but shorter post‐operative hospital stay (P = 0.002) and decreased morbidity (P = 0.018) in the unmatched cohort. Examination of peri‐operative outcomes after PSM revealed that MILR was similarly associated with a longer operating time (P = 0.001) and shortened post‐operative hospital stay (P = 0.043). OLR was associated with a significantly reduced application of Pringle manoeuvre (P = 0.004). There were no significant differences between MILR and OLR with regards to blood loss, blood transfusions, morbidity and margin status in the PSM analysis. Conclusion MILR for CLT is safe and feasible when performed by experienced surgeons. It is associated with shorter hospital stays but at the expense of longer operation times and more frequent application of Pringle manoeuver.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Chin

Linn

Cheong

et al. 2021

ANZ Journal of Surgery

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Safety and benefit of modified mesohepatectomy in the treatment of bilobar involvement congenital biliary dilatation

Jin,

Jiang,

Shan

et al. 2024

World j. surg.

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BackgroundThe diseased bile duct in bilobar congenital biliary dilatation is extensive and often requires major hepatectomy or liver transplantation associated with a higher risk. We aimed to evaluate the safety and benefit of modified mesohepatectomy, in comparison with trisectionectomy, to treat bilobar congenital biliary dilatation.MethodsThis study included 28 patients with type IV and V bilobar congenital biliary dilatation. An innovative mesohepatectomy comprising the hepatectomy technique beyond the P/U point and bile duct shaping was applied to 14 patients to address the extensively diseased bile duct and difficulty in hepaticojejunostomy. Another 14 patients received trisectionectomy. The perioperative and long‐term outcomes of these patients were compared.ResultsThe ratio of residual liver volume to standard liver volume in the mesohepatectomy group was higher (78.68% vs. 40.90%, p = 0.005), while the resection rate of the liver parenchyma was lower (28.25% vs. 63.97%, p = 0.000), than that in trisectionectomy group. The mesohepatectomy group had a lower severe complication (>Clavein III, 0% vs. 57.70%, p = 0.019) and incidence of posthepatectomy liver failure (7.14% vs. 42.86%, p = 0.038). No significant difference was observed in blood loss and bile leakage (p > 0.05). All the patients in the mesohepatectomy group achieved optimal results in the long‐term follow‐up.Conclusionsmesohepatectomy provides an efficient treatment option for bilobar congenital biliary dilatation and can achieve radical resection, retain more liver parenchyma, and reduce the difficulty of hepaticojejunostomy, especially for patients that are not eligible for major hepatectomy and liver transplantation.

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Minimally invasive mesohepatectomy for centrally located liver lesions—a case series

et al. 2022

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Background Resection of centrally located liver lesions remains a technically demanding procedure. To date, there are limited data on the effectiveness and safety of minimally invasive mesohepatectomy for benign and malignant lesions. It was therefore the objective of this study to evaluate the perioperative outcomes of minimally invasive mesohepatectomy for liver tumors at a tertiary care hospital. Methods Consecutive patients who underwent a minimally invasive anatomic mesohepatectomy using a Glissonean pedicle approach from April 2018 to November 2021 were identified from a prospective database. Demographics, operative details, and postoperative outcomes were analyzed using descriptive statistics for continuous and categorical variables. Results A total of ten patients were included, of whom five patients had hepatocellular carcinoma, one patient had cholangiocarcinoma, three patients had colorectal liver metastases, and one patient had a hydatid cyst. Two and eight patients underwent robotic-assisted and laparoscopic resections, respectively. The median operative time was 393 min (interquartile range (IQR) 298–573 min). Conversion to laparotomy was required in one case. The median lesion size was 60 mm and all cases had negative resection margins on final histopathological analysis. The median total blood loss was 550 ml (IQR 413–850 ml). One patient had a grade III complication. The median length of stay was 7 days (IQR 5–12 days). Time-to-functional recovery was achieved after a median of 2 days (IQR 1–4 days). There were no readmissions within 90 days after surgery. Conclusion Minimally invasive mesohepatectomy is a feasible and safe approach in selected patients with benign and malignant liver lesions.

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Laparoscopic versus open mesohepatectomy for patients with centrally located hepatocellular carcinoma: a propensity score matched analysis

Cited by 16 publications

References 50 publications

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Safety and benefit of modified mesohepatectomy in the treatment of bilobar involvement congenital biliary dilatation

Minimally invasive mesohepatectomy for centrally located liver lesions—a case series

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