TY - JOUR
T1 - Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry
AU - Levi Sandri, Giovanni Battista
AU - Ettorre, Giuseppe Maria
AU - Aldrighetti, Luca
AU - Cillo, Umberto
AU - Dalla Valle, Raffaele
AU - Guglielmi, Alfredo
AU - Mazzaferro, Vincenzo
AU - Ferrero, Alessandro
AU - Di Benedetto, Fabrizio
AU - Gruttadauria, Salvatore
AU - De Carlis, Luciano
AU - Vennarecci, Giovanni
AU - Antonucci, Adelmo
AU - Antonucci, Anna Maria
AU - Belli, Giulio
AU - Berti, Stefano
AU - Boggi, Ugo
AU - Bonsignore, Pasquale
AU - Brolese, Alberto
AU - Calise, Fulvio
AU - Ceccarelli, Graziano
AU - Colledan, Michele
AU - Coratti, Andrea
AU - Ferla, Fabio
AU - Floridi, Antonio
AU - Frena, Antonio
AU - Giuliani, Antonio
AU - Giuliante, Felice
AU - Grazi, Gian Luca
AU - Gringeri, Enrico
AU - Griseri, Guido
AU - Iaria, Maurizio
AU - Jovine, Elio
AU - Magistri, Paolo
AU - Maida, Pietro
AU - Mezzatesta, Pietro
AU - Russolillo, Nadia
AU - Navarra, Giuseppe
AU - Parisi, Amilcare
AU - Parisi, Carmelo Maria Antonio
AU - Pinna, Antonio Daniele
AU - Ratti, Francesca
AU - Rossi, Giorgio Ettore
AU - Ruzzenente, Andrea
AU - Santambrogio, Roberto
AU - Scotti, Andrea
AU - Sgroi, Giovanni
AU - Slim, Abdallah
AU - Torzilli, Guido
AU - Vincenti, Leonardo
AU - Virdis, Matteo
AU - Zamboni, Fausto
PY - 2019
Y1 - 2019
N2 - Objective: Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality. Methods: 38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1. Results: Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS. Conclusions: These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.
AB - Objective: Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality. Methods: 38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1. Results: Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS. Conclusions: These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.
KW - Aged
KW - Blood Transfusion
KW - Carcinoma, Hepatocellular
KW - Child B
KW - Female
KW - Hepatectomy
KW - Hepatocellular carcinoma
KW - Humans
KW - IGoMILS
KW - Italy
KW - Laparoscopic HCC
KW - Laparoscopic liver resection
KW - Laparoscopy
KW - Liver Neoplasms
KW - Male
KW - Margins of Excision
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Operative Time
KW - Posterior segment
KW - Postoperative Care
KW - Postoperative Complications
KW - Prospective Studies
KW - Registries
KW - Aged
KW - Blood Transfusion
KW - Carcinoma, Hepatocellular
KW - Child B
KW - Female
KW - Hepatectomy
KW - Hepatocellular carcinoma
KW - Humans
KW - IGoMILS
KW - Italy
KW - Laparoscopic HCC
KW - Laparoscopic liver resection
KW - Laparoscopy
KW - Liver Neoplasms
KW - Male
KW - Margins of Excision
KW - Matched-Pair Analysis
KW - Middle Aged
KW - Operative Time
KW - Posterior segment
KW - Postoperative Care
KW - Postoperative Complications
KW - Prospective Studies
KW - Registries
UR - http://hdl.handle.net/10807/181067
U2 - 10.1007/s00464-018-6426-3
DO - 10.1007/s00464-018-6426-3
M3 - Article
SN - 0930-2794
VL - 33
SP - 1451
EP - 1458
JO - Surgical Endoscopy
JF - Surgical Endoscopy
ER -