-Original-

Effectiveness of Laparoscopic Repeat Hepatectomy for Recurrent Liver Cancer

Masato Yoshioka¹, Nobuhiko Taniai², Youichi Kawano³, Tetsuya Shimizu¹, Ryota Kondo¹, Yohei Kaneya¹, Yuto Aoki¹ and Hiroshi Yoshida¹

¹Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan
²Department of Gastroenterological Surgery, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
³Department of Gastroenterological Surgery, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan

Background: Patients with recurrent hepatocellular carcinoma or metastatic liver cancer from colorectal cancer after surgical resection have traditionally been treated with conventional open surgery. However, recent technical advances have facilitated laparoscopic repeat hepatectomy (LapRH), which has advantages over open laparotomy. We describe the results of LapRH at our institution and retrospectively compare short-term outcomes after LapRH and initial laparoscopic partial liver resection (LapPLR).
Methods: From April 2010 through December 2017, 24 patients (16 men, 8 women; median age, 69 years) underwent LRH for cancer recurrence or metastasis after initial partial hepatectomy at our institution. LapRH involved partial hepatectomy in 21 patients and lateral segmentectomy in 3 patients. Short-term outcomes (operative time, intraoperative blood loss, and postoperative hospital stay) for these 24 patients were compared with those for 117 patients who underwent initial LapPLR during the same period.
Results: There were no significant differences between the LapPLR and LapRH groups in baseline characteristics, including patient age and underlying disease. No LapRH procedure required conversion to open surgery. There were no statistically significant differences between the groups in median operation time (268 min for LapPLR, 294 min for LapRH; p = 0.55), blood loss (224.0 mL for LapPLR, 77.5 mL for LapRH; p = 0.76), or length of hospital stay (11.0 days for LapPLR, 10.2 days for LapRH; p = 0.83).
Conclusions: LapRH for recurrent liver cancer yielded satisfactory outcomes when compared with those of initial hepatectomy. Further studies are needed, however, to confirm the present results.

J Nippon Med Sch 2019; 86: 222-229

Keywords
reoperation, hepatectomy, laparoscopy, adhesions

Correspondence to
Masato Yoshioka, MD, PhD, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
y-masato@nms.ac.jp

Received, December 4, 2018
Accepted, April 25, 2019