論文種別 原著(症例報告除く)
言語種別 英語
査読の有無 その他(不明)
表題 Laparoscopic versus open sectionectomy and bisectionectomy for hepatocellular carcinoma: a propensity score-matched analysis of short- and long-term outcomes.
掲載誌名 正式名:Surgical endoscopy
略  称:Surg Endosc
ISSNコード:14322218/09302794
掲載区分国外
巻・号・頁 pp.Online ahead of print
著者・共著者 Thanh Tung Lai, Kosuke Matsui, Hisashi Kosaka, Hideyuki Matsushima, Hidekazu Yamamoto, Gozo Kiguchi, Takuya Ohigashi, Van Khanh Nguyen, Hoang Hai Duong, Kyoko Inoue, Moriyasu Takada, Kengo Yoshii, Masaki Kaibori
発行年月 2026/08
概要 BACKGROUND:This study aimed to compare short- and long-term outcomes of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) in patients with HCC who underwent sectionectomies or bisectionectomies.METHODS:From 2018 to 2023, HCC patients who underwent a sectionectomy or bisectionectomy were retrospectively analyzed. Propensity score matching (PSM) was used to assess the association of operative approaches with short- and long-term outcomes.RESULTS:Among 112 patients with HCC, 49 (43.8%) and 63 (56.2%) underwent LH and OH, respectively. Compared with OH, LH was respectively associated with lower blood loss (844 vs. 307 mL, p < 0.001), shorter hospital stay (20 vs. 15 days, p = 0.010), lower rates of severe postoperative complications (33% vs. 14%, p = 0.032) and overall infections (40% vs. 20%, p = 0.029), and organ/space surgical site infections (30% vs. 10%, p = 0.011). After PSM, LH remained superior regarding blood loss, hospital stay, severe postoperative complications, overall infections, and organ/space SSIs (323 mL, 15 days, 17, 19, and 11% vs. 762 mL, 22 days, 39, 47, and 36%, respectively). The patients undergoing LH had lower C-reactive protein (CRP) levels (p = 0.006), longer prothrombin time (p = 0.012), and higher cholinesterase levels (p = 0.046) than the patients undergoing OH throughout the postoperative period. The differences between the 5-year OS (57.1% vs. 46.7%, p = 0.685) and RFS (34.9% vs. 26.8%, p = 0.475) rates of the respective LH and OH patients were not significant.CONCLUSIONS:Laparoscopic sectionectomies and bisectionectomies for patients with HCC are feasible and safe, with better short-term outcomes than open sectionectomies and bisectionectomies, and provide similar long-term outcomes.
DOI 10.1007/s00464-026-12978-0
PMID 42587043