Mini-Invasive Approach Contributes to Expand the Indication for Liver Resection for Hepatocellular Carcinoma Without Increasing the Incidence of Posthepatectomy Liver Failure and Other Perioperative Complications: A Single-Center Analysis

Salvatore Gruttadauria, Alessandro Tropea, Duilio Pagano, Aurelia Guarini, Rosa Liotta, Tian Ling, Fabio Tuzzolino, Angelo Luca, Giovanni Vizzini, Bruno Gridelli

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Liver resection (LR) for hepatocellular carcinoma (HCC) is the best alternative option for increasing the survival of many patients with intermediate or advanced stages of the Barcelona Clinic Liver Cancer staging classification. Mini-invasive approach may play a positive role in treating a tumor rising almost exclusively in a diseased liver. Methods: A prospectively collected database was retrospectively reviewed for 167 consecutive patients who underwent LR between 1999 and 2015. Results: A total of 38 LRs were performed from 1999 to 2009 (Period I), and 129 between 2010 and 2015 (Period II). Laparoscopic procedures increased from 5.3% to 38.1%. Not undergoing laparoscopic LR increased length of stay, and Clavien Grade II or worse complications. Ninety-day mortality decreased from 5.2% to 0%, and morbidity did not differ significantly, despite the fact that the most complex patients were in Period II. Conclusions: Mini-invasive approaches allow to safely expand limits of LR for HCC; in particular, laparoscopic approach favors surgical option even in more complex patients without increase the risk of posthepatic liver failure or other postsurgical complications.

Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume26
Issue number6
DOIs
Publication statusPublished - Jun 1 2016

ASJC Scopus subject areas

  • Surgery

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