Cargando…
Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study
AIM: This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). METHODS: The clinical records of 339 and 733 patients who u...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786695/ https://www.ncbi.nlm.nih.gov/pubmed/35106424 http://dx.doi.org/10.1002/ags3.12506 |
_version_ | 1784639171441197056 |
---|---|
author | Ishihara, Atsushi Tanaka, Shogo Shinkawa, Hiroji Yoshida, Hisako Takemura, Shigekazu Amano, Ryosuke Kimura, Kenjiro Ohira, Go Nishio, Kohei Kubo, Shoji |
author_facet | Ishihara, Atsushi Tanaka, Shogo Shinkawa, Hiroji Yoshida, Hisako Takemura, Shigekazu Amano, Ryosuke Kimura, Kenjiro Ohira, Go Nishio, Kohei Kubo, Shoji |
author_sort | Ishihara, Atsushi |
collection | PubMed |
description | AIM: This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). METHODS: The clinical records of 339 and 733 patients who underwent LLR and OLR, respectively, for HCC between 2000 and 2019 were retrospectively reviewed. Body mass index (BMI) groups were classified according to the definitions of the World Health Organization: underweight group, BMI ≤ 18.4 kg/m(2) (LLR vs OLR: 27 vs 47); normal weight, BMI 18.5‐24.9 kg/m(2) (211 vs 483); overweight, BMI 25.0‐29.9 kg/m(2) (85 vs 181); and obese, BMI ≥ 30.0 kg/m(2) (16 vs 22). The effects of obesity on major complications after LLR and OLR were investigated. RESULTS: In total, 18 (5.3%) and 127 (17.3%) patients presented with major complications after LLR and OLR, respectively. There was no significant difference in the incidence of major complications after OLR in the four BMI groups. However, a stepwise decrease in the incidence of major complications after LLR was observed from the underweight to the obese group. In addition, a multivariate analysis revealed that increased BMI was an independent preventive factor for major complications after LLR (P = .026, odds ratio: 0.84). The estimated adjusted risk of major postoperative complications decreased with increased BMI in the LLR group, while the risk did not decrease in the OLR group (P for interaction = .048). CONCLUSION: Laparoscopic liver resection is beneficial for obese patients and is superior to OLR. |
format | Online Article Text |
id | pubmed-8786695 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87866952022-01-31 Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study Ishihara, Atsushi Tanaka, Shogo Shinkawa, Hiroji Yoshida, Hisako Takemura, Shigekazu Amano, Ryosuke Kimura, Kenjiro Ohira, Go Nishio, Kohei Kubo, Shoji Ann Gastroenterol Surg Original Articles AIM: This study aimed to elucidate the effects of laparoscopic liver resection (LLR) vs open liver resection (OLR) for major complications (Clavien‐Dindo classification grade ≥ IIIa) in obese individuals with hepatocellular carcinoma (HCC). METHODS: The clinical records of 339 and 733 patients who underwent LLR and OLR, respectively, for HCC between 2000 and 2019 were retrospectively reviewed. Body mass index (BMI) groups were classified according to the definitions of the World Health Organization: underweight group, BMI ≤ 18.4 kg/m(2) (LLR vs OLR: 27 vs 47); normal weight, BMI 18.5‐24.9 kg/m(2) (211 vs 483); overweight, BMI 25.0‐29.9 kg/m(2) (85 vs 181); and obese, BMI ≥ 30.0 kg/m(2) (16 vs 22). The effects of obesity on major complications after LLR and OLR were investigated. RESULTS: In total, 18 (5.3%) and 127 (17.3%) patients presented with major complications after LLR and OLR, respectively. There was no significant difference in the incidence of major complications after OLR in the four BMI groups. However, a stepwise decrease in the incidence of major complications after LLR was observed from the underweight to the obese group. In addition, a multivariate analysis revealed that increased BMI was an independent preventive factor for major complications after LLR (P = .026, odds ratio: 0.84). The estimated adjusted risk of major postoperative complications decreased with increased BMI in the LLR group, while the risk did not decrease in the OLR group (P for interaction = .048). CONCLUSION: Laparoscopic liver resection is beneficial for obese patients and is superior to OLR. John Wiley and Sons Inc. 2021-09-16 /pmc/articles/PMC8786695/ /pubmed/35106424 http://dx.doi.org/10.1002/ags3.12506 Text en © 2021 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Ishihara, Atsushi Tanaka, Shogo Shinkawa, Hiroji Yoshida, Hisako Takemura, Shigekazu Amano, Ryosuke Kimura, Kenjiro Ohira, Go Nishio, Kohei Kubo, Shoji Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title_full | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title_fullStr | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title_full_unstemmed | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title_short | Superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: A retrospective study |
title_sort | superiority of laparoscopic liver resection to open liver resection in obese individuals with hepatocellular carcinoma: a retrospective study |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786695/ https://www.ncbi.nlm.nih.gov/pubmed/35106424 http://dx.doi.org/10.1002/ags3.12506 |
work_keys_str_mv | AT ishiharaatsushi superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT tanakashogo superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT shinkawahiroji superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT yoshidahisako superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT takemurashigekazu superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT amanoryosuke superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT kimurakenjiro superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT ohirago superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT nishiokohei superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy AT kuboshoji superiorityoflaparoscopicliverresectiontoopenliverresectioninobeseindividualswithhepatocellularcarcinomaaretrospectivestudy |