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Approaches of laparoscopic anatomical liver resection of segment 8 for hepatocellular carcinoma: A retrospective cohort study of short-term results at multiple centers in China

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机构: [1]Department of Hepatobiliary Surgery, Qujing Second People's Hospital of Yunnan Province, Qujing, China. [2]Chinese Research Group for Minimally Invasive Anatomical Liver Resection (CRG-MIALR). [3]Department of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China. [4]Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. [5]Division of Hepatobiliopancreatic Surgery, Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China. [6]Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China. [7]Xiangyue Hospital Affiliated to Hunan Institute of Parasitic Diseases, National Clinical Center for Schistosomiasis Treatment, Yueyang, Hunan, China. [8]Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. [9]Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan, China. [10]Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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关键词: Glissonean approach hepatic vein-guided approach hepatocellular carcinoma laparoscopic anatomical liver resection of segment 8

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Laparoscopic anatomical liver resection of segment 8 (LALR-S8) remains a challenge for anatomical laparoscopic segmentectomy. Most current reports on LALR-S8 are case series using one surgical approach, and there is a lack of multicenter data on identifying intersegmental planes using different approaches. In this study, we aimed to elucidate the short-term results of three different approaches for LALR-S8 for hepatocellular carcinoma (HCC), focusing on intersegmental plane determination, and to reflect on current practice regarding different approaches at multiple centers in China.The clinical cohort data of 122 patients who underwent LALR-S8 for HCC at seven leading centers in China were retrospectively analyzed. The surgical procedures of all approaches were summarized and standardized according to the method of the Glissonean pedicle of segment 8 identification. The postoperative short-term outcomes and oncological results of the three approaches were evaluated and compared.Three approaches were used: laparoscopic ultrasonography-guided indocyanine green (ICG) fluorescent positive staining approach (11/122, 9.02%), hepatic vein-guided approach (99/122, 81.15%), and Glissonean ICG fluorescent negative staining approach (12/122, 9.83%). Seven (5.73%) patients experienced complications according to the Clavien-Dindo (CD) classification, and the rate of grade ≥IIIa complications was 2.46%. The R0 resection rates among the groups (margin >1 mm) and the margin width showed no statistical difference.LALR-S8 is safe and feasible for treating HCC under standardized surgical techniques and appropriate surgical approaches. The three reported approaches had comparable short-term oncological outcomes, while the hepatic vein-guided approach was most commonly used.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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出版当年[2023]版:
大类 | 2 区 医学
小类 | 2 区 外科
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者机构: [1]Department of Hepatobiliary Surgery, Qujing Second People's Hospital of Yunnan Province, Qujing, China. [2]Chinese Research Group for Minimally Invasive Anatomical Liver Resection (CRG-MIALR).
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通讯机构: [2]Chinese Research Group for Minimally Invasive Anatomical Liver Resection (CRG-MIALR). [10]Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. [*1]Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100000, China
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