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Laparoscopy of hepatocellular carcinoma is helpful in minimizing intra-abdominal adhesion during salvage transplantation

Annals of Surgical Treatment and Research 2018년 95권 5호 p.258 ~ 266
KMID : 0371420180950050258
 ( Rhu Jin-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery

 ( Kim Jong-Man ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Choi Gyu-Seong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Kwon Choon-Hyuck David ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Joh Jae-Won ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Surgery
 ( Soubrane Olivier ) - Hospital Beaujon Hepatobiliary-Pancreatic Surgery

Abstract

Purpose: This study analyzes the impact of laparoscopic liver resection on intra-abdominal adhesion.

Methods: Patients who underwent salvage liver transplantation after liver resection for hepatocellular carcinoma from January 2012 to October 2017 at our institution were included. Information about the severity of intra-abdominal adhesions was collected from a prospectively maintained database. Intra-abdominal adhesions were graded after the agreement of 2 surgeons who participated in the salvage liver transplantation based on predetermined criteria. Adhesion severity and demographic, operative, and postoperative data were compared between the laparoscopic group and the open group. Multivariate logistic regression was performed to consider potential factors related to severe adhesion during salvage transplantation.

Results: Sixty-two patients who underwent salvage liver transplantation after liver resection were included in this study. Among them, 52 patients underwent open surgery, and 10 patients underwent laparoscopy. Adhesion was significantly more severe in the open group than in the laparoscopy group (P = 0.029). A multivariate logistic regression model including potential factors related to severe adhesion showed that laparoscopy (odds ratio, 0.168; 95% confidence interval, 0.029?0.970; P = 0.048) was the only significant factor.

Conclusion: Laparoscopic liver resection for hepatocellular carcinoma can minimize intra-abdominal adhesion during salvage liver transplantation.
KeyWords

H epatocellular carcinoma, Laparoscopy, Liver transplantation, Surgical adhesion
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