Impact of liver cirrhosis, severity of cirrhosis and portal hypertension on the difficulty of laparoscopic and robotic minor liver resections for primary liver malignancies in the anterolateral segments
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Zheng, JunhaoLiang, Xiao
Wu, Andrew G R
Kabir, Tousif
Scatton, Olivier
Lim, Chetana
Hasegawa, Kiyoshi
Sijberden, Jasper P
Aghayan, Davit L
Siow, Tiing Foong
Dokmak, Safi
Herman, Paulo
Marino, Marco V
Mazzaferro, Vincenzo
Chiow, Adrian K H
Sucandy, Iswanto
Ivanecz, Arpad
Choi, Sung Hoon
Lee, Jae Hoon
Prieto, Mikel
Vivarelli, Marco
Giuliante, Felice
Ruzzenente, Andrea
Yong, Chee-Chien
Yin, Mengqiu
Chen, Zewei
Fondevila, Constantino
Efanov, Mikhail
Morise, Zenichi
Di Benedetto, Fabrizio
Brustia, Raffaele
Dalla Valle, Raffaele
Boggi, Ugo
Geller, David
Belli, Andrea
Memeo, Riccardo
Gruttadauria, Salvatore
Mejia, Alejandro
Park, James O
Rotellar, Fernando
Choi, Gi-Hong
Robles-Campos, Ricardo
Wang, Xiaoying
Sutcliffe, Robert P
Pratschke, Johann
Lai, Eric C H
Chong, Charing C N
D'Hondt, Mathieu
Monden, Kazuteru
Lopez-Ben, Santiago
Kingham, T Peter
Ferrero, Alessandro
Ettorre, Giuseppe Maria
Cherqui, Daniel
Cipriani, Federica
Soubrane, Olivier
Zhang, Wanguang
Wakabayashi, Go
Troisi, Roberto I
Cheung, Tan-To
Kato, Yutaro
Sugioka, Atsushi
Long, Tran Cong Duy
Liu, Rong
Edwin, Bjørn
Fuks, David
Abu Hilal, Mohammad
Chen, Kuo-Hsin
Aldrighetti, Luca
Han, Ho-Seong
Goh, Brian K P
Publication date
2023-11-08
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Introduction: We performed this study in order to investigate the impact of liver cirrhosis (LC) on the difficulty of minimally invasive liver resection (MILR), focusing on minor resections in anterolateral (AL) segments for primary liver malignancies. Methods: This was an international multicenter retrospective study of 3675 patients who underwent MILR across 60 centers from 2004 to 2021. Results: 1312 (35.7%) patients had no cirrhosis, 2118 (57.9%) had Child A cirrhosis and 245 (6.7%) had Child B cirrhosis. After propensity score matching (PSM), patients in Child A cirrhosis group had higher rates of open conversion (p = 0.024), blood loss >500 mls (p = 0.001), blood transfusion (p < 0.001), postoperative morbidity (p = 0.004), and in-hospital mortality (p = 0.041). After coarsened exact matching (CEM), Child A cirrhotic patients had higher open conversion rate (p = 0.05), greater median blood loss (p = 0.014) and increased postoperative morbidity (p = 0.001). Compared to Child A cirrhosis, Child B cirrhosis group had longer postoperative stay (p = 0.001) and greater major morbidity (p = 0.012) after PSM, and higher blood transfusion rates (p = 0.002), longer postoperative stay (p < 0.001), and greater major morbidity (p = 0.006) after CEM. After PSM, patients with portal hypertension experienced higher rates of blood loss >500 mls (p = 0.003) and intraoperative blood transfusion (p = 0.025). Conclusion: The presence and severity of LC affect and compound the difficulty of MILR for minor resections in the AL segments. These factors should be considered for inclusion into future difficulty scoring systems for MILR.Citation
Zheng J, Liang X, Wu AGR, Kabir T, Scatton O, Lim C, Hasegawa K, Sijberden JP, Aghayan DL, Siow TF, Dokmak S, Herman P, Marino MV, Mazzaferro V, Chiow AKH, Sucandy I, Ivanecz A, Choi SH, Lee JH, Prieto M, Vivarelli M, Giuliante F, Ruzzenente A, Yong CC, Yin M, Chen Z, Fondevila C, Efanov M, Morise Z, Di Benedetto F, Brustia R, Dalla Valle R, Boggi U, Geller D, Belli A, Memeo R, Gruttadauria S, Mejia A, Park JO, Rotellar F, Choi GH, Robles-Campos R, Wang X, Sutcliffe RP, Pratschke J, Lai ECH, Chong CCN, D'Hondt M, Monden K, Lopez-Ben S, Kingham TP, Ferrero A, Ettorre GM, Cherqui D, Cipriani F, Soubrane O, Zhang W, Wakabayashi G, Troisi RI, Cheung TT, Kato Y, Sugioka A, Long TCD, Liu R, Edwin B, Fuks D, Abu Hilal M, Chen KH, Aldrighetti L, Han HS, Goh BKP; International robotic and laparoscopic liver resection study group investigators. Impact of liver cirrhosis, severity of cirrhosis and portal hypertension on the difficulty of laparoscopic and robotic minor liver resections for primary liver malignancies in the anterolateral segments. Eur J Surg Oncol. 2024 Jan;50(1):107252. doi: 10.1016/j.ejso.2023.107252. Epub 2023 Nov 8.Type
ArticlePMID
37984243Publisher
Academic Pressae974a485f413a2113503eed53cd6c53
10.1016/j.ejso.2023.107252