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Preoperative transarterial chemoembolization for laparoscopic liver resection in Child A cirrhotic patients with hepatocellular carcinoma
- Source :
- Langenbeck's archives of surgery. 406(3)
- Publication Year :
- 2020
-
Abstract
- Laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) offers better short-term results than open surgery with similar long-term results although it is technically difficult due to the risk of bleeding. This study included patients with HCC in Child A cirrhosis who underwent TACE before LLR between 2009 and 2019. The primary endpoint was to analyze the intraoperative and early results of this technique. We also analyzed the long-term outcomes. Patients with and without clinically significant portal hypertension (CSPH) were compared. A total of 44 cirrhotic patients with HCC were included (24 CSPH and 20 non-CSPH). The Pringle maneuver was used in two cases (4.5%), mean blood losses was 100 ml (range 50–200), and three patients (6.8%) required a blood transfusion. The degree of necrosis achieved was greater than 90% in 27 patients (61.4%). At 1, 3, and 5 years, overall survival was 97.7%, 81.5%, and 63.4%, respectively, and disease-free survival was 85.2%, 52.5%, and 34.5%, respectively. There were no statistically significant differences between non-CSPH and CSPH groups regarding intraoperative, early, and long-term outcomes. In our experience, TACE could be beneficial to perform LLR in HCC Child–Pugh A patients with and without CSPH without serious complications and similar oncological outcomes.
- Subjects :
- Liver Cirrhosis
medicine.medical_specialty
Blood transfusion
Cirrhosis
Carcinoma, Hepatocellular
medicine.medical_treatment
030230 surgery
03 medical and health sciences
0302 clinical medicine
medicine
Clinical endpoint
Humans
Chemoembolization, Therapeutic
Laparoscopy
medicine.diagnostic_test
business.industry
Liver Neoplasms
medicine.disease
Surgery
Cardiothoracic surgery
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Portal hypertension
business
Abdominal surgery
Subjects
Details
- ISSN :
- 14352451
- Volume :
- 406
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Langenbeck's archives of surgery
- Accession number :
- edsair.doi.dedup.....164407514e7285e0d2e005af26027217