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The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation
BACKGROUND: The aim of this study was to compare the effectiveness of laparoscopic liver resection (LLR) and laparoscopic radiofrequency ablation (LRFA) in the treatment of small nodular hepatocellular carcinoma (HCC). PATIENTS AND METHODS: We enrolled 50 cirrhotic patients with similar baseline cha...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4640020/ https://www.ncbi.nlm.nih.gov/pubmed/26622111 http://dx.doi.org/10.4103/0972-9941.144093 |
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author | Casaccia, Marco Santori, Gregorio Bottino, Giuliano Diviacco, Pietro Negri, Antonella De Moraglia, Eva Adorno, Enzo |
author_facet | Casaccia, Marco Santori, Gregorio Bottino, Giuliano Diviacco, Pietro Negri, Antonella De Moraglia, Eva Adorno, Enzo |
author_sort | Casaccia, Marco |
collection | PubMed |
description | BACKGROUND: The aim of this study was to compare the effectiveness of laparoscopic liver resection (LLR) and laparoscopic radiofrequency ablation (LRFA) in the treatment of small nodular hepatocellular carcinoma (HCC). PATIENTS AND METHODS: We enrolled 50 cirrhotic patients with similar baseline characteristics that underwent LLR (n = 26) or LRFA (n = 24), in both cases with intraoperative ultrasonography. Operative and peri-operative data were retrospectively evaluated. RESULTS: LLR included anatomic resection in eight cases and non-anatomic resection in 18. In LRFA patients, a thermoablation of 62 nodules was achieved. Between LLR and LRFA groups, a significant difference was found both for median diameters of treated HCC nodules (30 vs. 17.1 mm; P < 0.001) and the number of treated nodules/patient (1.29 ± 0.62 vs. 2.65 ± 1.55; P < 0.001). A conversion to laparotomy occurred in two LLR patient (7.7%) for bleeding. No deaths occurred in both groups. Morbidity rates were 26.9% in the LLR group versus 16.6% in the LRFA group (P = 0.501). Hospital stay in the LLR and LRFA group was 8.30 ± 6.52 and 6.52 ± 2.69 days, respectively (P = 0.022). The surgical margin was free of tumour cells in all LLR patients, with a margin <5 mm in only one case. In the LRFA group, a complete response was achieved in 90.3% of thermoablated HCC nodules at the 1-month post-treatment computed tomography evaluation. CONCLUSIONS: LLR for small peripheral HCC in patients with chronic liver disease represents a valid alternative to LRFA in terms of patient toleration, surgical outcome of the procedure, and short-term morbidity. |
format | Online Article Text |
id | pubmed-4640020 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-46400202015-11-30 The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation Casaccia, Marco Santori, Gregorio Bottino, Giuliano Diviacco, Pietro Negri, Antonella De Moraglia, Eva Adorno, Enzo J Minim Access Surg Original Article BACKGROUND: The aim of this study was to compare the effectiveness of laparoscopic liver resection (LLR) and laparoscopic radiofrequency ablation (LRFA) in the treatment of small nodular hepatocellular carcinoma (HCC). PATIENTS AND METHODS: We enrolled 50 cirrhotic patients with similar baseline characteristics that underwent LLR (n = 26) or LRFA (n = 24), in both cases with intraoperative ultrasonography. Operative and peri-operative data were retrospectively evaluated. RESULTS: LLR included anatomic resection in eight cases and non-anatomic resection in 18. In LRFA patients, a thermoablation of 62 nodules was achieved. Between LLR and LRFA groups, a significant difference was found both for median diameters of treated HCC nodules (30 vs. 17.1 mm; P < 0.001) and the number of treated nodules/patient (1.29 ± 0.62 vs. 2.65 ± 1.55; P < 0.001). A conversion to laparotomy occurred in two LLR patient (7.7%) for bleeding. No deaths occurred in both groups. Morbidity rates were 26.9% in the LLR group versus 16.6% in the LRFA group (P = 0.501). Hospital stay in the LLR and LRFA group was 8.30 ± 6.52 and 6.52 ± 2.69 days, respectively (P = 0.022). The surgical margin was free of tumour cells in all LLR patients, with a margin <5 mm in only one case. In the LRFA group, a complete response was achieved in 90.3% of thermoablated HCC nodules at the 1-month post-treatment computed tomography evaluation. CONCLUSIONS: LLR for small peripheral HCC in patients with chronic liver disease represents a valid alternative to LRFA in terms of patient toleration, surgical outcome of the procedure, and short-term morbidity. Medknow Publications & Media Pvt Ltd 2015 /pmc/articles/PMC4640020/ /pubmed/26622111 http://dx.doi.org/10.4103/0972-9941.144093 Text en Copyright: © 2015 Journal of Minimal Access Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Casaccia, Marco Santori, Gregorio Bottino, Giuliano Diviacco, Pietro Negri, Antonella De Moraglia, Eva Adorno, Enzo The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title | The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title_full | The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title_fullStr | The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title_full_unstemmed | The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title_short | The procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
title_sort | procedure outcome of laparoscopic resection for ‘small’ hepatocellular carcinoma is comparable to vlaparoscopic radiofrequency ablation |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4640020/ https://www.ncbi.nlm.nih.gov/pubmed/26622111 http://dx.doi.org/10.4103/0972-9941.144093 |
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