دورية أكاديمية
أعرض في EDS

Minimally Invasive Versus Open Liver Resections for Hepatocellular Carcinoma in Patients With Metabolic Syndrome.

التفاصيل البيبلوغرافية
العنوان: Minimally Invasive Versus Open Liver Resections for Hepatocellular Carcinoma in Patients With Metabolic Syndrome.
المؤلفون: Berardi G; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.; Department of Surgery, San Camillo Forlanini Hospital, Rome, Italy., Ivanics T; Department of Surgery, University of Toronto, Toronto, ON, Canada., Sapisochin G; Department of Surgery, University of Toronto, Toronto, ON, Canada., Ratti F; Division, San Raffaele Hospital, Hepatobiliary Surgery Milan, Italy., Sposito C; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.; Department of Surgery, HPB Surgery and Liver Transplantation, Istituto Nazionale Tumori IRCCS, Milan, Italy., Nebbia M; Department of Surgery, Massachusetts General Hospital, Boston, MA., D'Souza DM; Department of Surgery, McMaster University, Hamilton, ON, Canada., Pascual F; Department of Surgery, Paul Brousse Hospital, Villejuif, Paris, France., Tohme S; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA., D'Amico FE; Department of Surgery, University of Padua, Padua, Italy., Alessandris R; Department of Surgery, University of Padua, Padua, Italy., Panetta V; L'altrastatistica Consultancy and Training, Biostatistics Department, Rome, Italy., Simonelli I; L'altrastatistica Consultancy and Training, Biostatistics Department, Rome, Italy., Del Basso C; Department of Surgery, San Camillo Forlanini Hospital, Rome, Italy., Russolillo N; Department of Surgery, Mauriziano Hospital, Turin, Italy., Fiorentini G; Department of Surgery, Mayo Clinic, Rochester, NY., Serenari M; Hepatobiliary surgery and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy., Rotellar F; Hepatobiliary and Liver Transplantation Unit, Department of Surgery, University Clinic, Universidad de Navarra, Pamplona, Spain; Institute of Health Research of Navarra (IdisNA), Pamplona, Spain., Zimitti G; Department of surgery, Poliambulanza Foundation Hospital, Brescia, Italy., Famularo S; Department of General Surgery, Humanitas University and Research Hospital, IRCCS, Milan, Italy., Hoffman D; Department of Surgery, University of California San Francisco, San Francisco, CA., Onkendi E; Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX., Lopez-Ben S; Department of Surgery, Hospital Universitari Dr Josep Trueta de Girona, Girona, Spain., Caula C; Department of Surgery, Hospital Universitari Dr Josep Trueta de Girona, Girona, Spain., Rompianesi G; Division of HPB, Minimally Invasive and Robotic Surgery, Transplantation Service, Federico II University Naples., Chopra A; Department of Surgery, Promedica Toledo, Toledo, OH., Abu Hilal M; Department of surgery, Poliambulanza Foundation Hospital, Brescia, Italy., Torzilli G; Department of General Surgery, Humanitas University and Research Hospital, IRCCS, Milan, Italy., Corvera C; Department of Surgery, University of California San Francisco, San Francisco, CA., Alseidi A; Department of Surgery, University of California San Francisco, San Francisco, CA., Helton S; Department of Surgery, Virginia Mason Hospital and Seattle Medical Center, Seattle, WA., Troisi RI; Division of HPB, Minimally Invasive and Robotic Surgery, Transplantation Service, Federico II University Naples., Simo K; Department of Surgery, Promedica Toledo, Toledo, OH., Conrad C; Department of Surgery, Saint Elizabeth Medical Center, Boston, MA., Cescon M; Hepatobiliary surgery and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Sant'Orsola-Malpighi Hospital, Bologna, Italy., Cleary S; Department of Surgery, Mayo Clinic, Rochester, NY., Kwon CHD; Department of Surgery, Cleveland Clinic, Cleveland, OH., Ferrero A; Department of Surgery, Mauriziano Hospital, Turin, Italy., Ettorre GM; Department of Surgery, San Camillo Forlanini Hospital, Rome, Italy., Cillo U; Department of Surgery, University of Padua, Padua, Italy., Geller D; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA., Cherqui D; Department of Surgery, Paul Brousse Hospital, Villejuif, Paris, France., Serrano PE; Department of Surgery, McMaster University, Hamilton, ON, Canada., Ferrone C; Department of Surgery, Massachusetts General Hospital, Boston, MA., Mazzaferro V; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.; Department of Surgery, HPB Surgery and Liver Transplantation, Istituto Nazionale Tumori IRCCS, Milan, Italy., Aldrighetti L; Division, San Raffaele Hospital, Hepatobiliary Surgery Milan, Italy., Kingham TP; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
المصدر: Annals of surgery [Ann Surg] 2023 Nov 01; Vol. 278 (5), pp. e1041-e1047. Date of Electronic Publication: 2023 Mar 30.
نوع المنشور: Multicenter Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Carcinoma, Hepatocellular*/complications , Carcinoma, Hepatocellular*/surgery , Liver Neoplasms*/complications , Liver Neoplasms*/surgery , Metabolic Syndrome*/complications , Metabolic Syndrome*/surgery , Liver Failure*/surgery , Laparoscopy*, Humans ; Ascites/complications ; Ascites/surgery ; Hepatectomy ; Propensity Score ; Length of Stay ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery
مستخلص: Objective: To compare minimally invasive (MILR) and open liver resections (OLRs) for hepatocellular carcinoma (HCC) in patients with metabolic syndrome (MS).
Background: Liver resections for HCC on MS are associated with high perioperative morbidity and mortality. No data on the minimally invasive approach in this setting exist.
Material and Methods: A multicenter study involving 24 institutions was conducted. Propensity scores were calculated, and inverse probability weighting was used to weight comparisons. Short-term and long-term outcomes were investigated.
Results: A total of 996 patients were included: 580 in OLR and 416 in MILR. After weighing, groups were well matched. Blood loss was similar between groups (OLR 275.9±3.1 vs MILR 226±4.0, P =0.146). There were no significant differences in 90-day morbidity (38.9% vs 31.9% OLRs and MILRs, P =0.08) and mortality (2.4% vs 2.2% OLRs and MILRs, P =0.84). MILRs were associated with lower rates of major complications (9.3% vs 15.3%, P =0.015), posthepatectomy liver failure (0.6% vs 4.3%, P =0.008), and bile leaks (2.2% vs 6.4%, P =0.003); ascites was significantly lower at postoperative day 1 (2.7% vs 8.1%, P =0.002) and day 3 (3.1% vs 11.4%, P <0.001); hospital stay was significantly shorter (5.8±1.9 vs 7.5±1.7, P <0.001). There was no significant difference in overall survival and disease-free survival.
Conclusions: MILR for HCC on MS is associated with equivalent perioperative and oncological outcomes to OLRs. Fewer major complications, posthepatectomy liver failures, ascites, and bile leaks can be obtained, with a shorter hospital stay. The combination of lower short-term severe morbidity and equivalent oncologic outcomes favor MILR for MS when feasible.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
التعليقات: Comment in: Hepatobiliary Surg Nutr. 2024 Aug 1;13(4):703-705. doi: 10.21037/hbsn-24-294. (PMID: 39175735)
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معلومات مُعتمدة: P30 CA008748 United States CA NCI NIH HHS
تواريخ الأحداث: Date Created: 20230330 Date Completed: 20231023 Latest Revision: 20240823
رمز التحديث: 20240823
مُعرف محوري في PubMed: PMC11218006
DOI: 10.1097/SLA.0000000000005861
PMID: 36994755
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1140
DOI:10.1097/SLA.0000000000005861