Page 13 - Read Online
P. 13

Otsuka et al. Hepatoma Res 2016;2:241-7                              Hepatoma Research
           DOI: 10.20517/2394-5079.2016.11
                                                                                                  www.hrjournal.net
            Topic: Advances in Minimally Invasive Cirrhotic Surgery                             Open Access

           Indications and technique for laparoscopic

           liver resection in patients with hepatocellular

           carcinoma and liver cirrhosis



           Yuichiro Otsuka, Masaru Tsuchiya, Toshio Katagiri, Yoshihisa Kubota, Jun Ishii, Tetsuya Maeda, Hironori Kaneko

           Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.
           Correspondence to: Dr. Hironori Kaneko, Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty
           of Medicine, 6-11-1, Omorinishi, Ota-ku, Tokyo 143-8541, Japan. E-mail: hironori@med.toho-u.ac.jp

           How to cite this article: Otsuka Y, Tsuchiya M, Katagiri T, Kubota Y, Ishii J, Maeda T, Kaneko H. Indications and technique for laparoscopic liver
           resection in patients with hepatocellular carcinoma and liver cirrhosis. Hepatoma Res 2016;2:241-7.


                                         ABSTRACT
            Article history:              Liver resection is the preferred initial treatment option for solitary or limited multifocal
            Received: 26-04-2016          hepatocellular carcinoma (HCC). However, because of the characteristics of HCC, including its
            Accepted: 12-07-2016          high recurrence rate and the frequent presence of chronic hepatitis and cirrhosis, both curability and
            Published: 19-09-2016         invasiveness must be considered when selecting a treatment for HCC. Laparoscopic liver resection
                                          (LLR) is minimally invasive and increasingly performed worldwide as a curative surgical option
                                          for treatment of liver tumors. The 2014 International Consensus Conference on LLR concluded
            Key words:                    that minor LLRs are now standard practice. Meta-analyses suggest that, as compared with open
            Laparoscopic liver resection,  hepatectomy, LLR for patients with HCC, including those with cirrhosis, resulted in less blood loss,
            hepatocellular carcinoma,     lower postoperative hospitalization rates, and similar oncological outcomes. Although candidates
            liver cirrhosis               for this procedure should be carefully evaluated, LLR appears to be a feasible option for treatment
                                          of HCC with liver cirrhosis. This review describes the indications for LLR in this patient subgroup
                                          and offers guidance on appropriate surgical technique.


           INTRODUCTION                                       spread. [2-6]  The mortality and morbidity of liver resection
                                                              have  significantly  decreased  in  the  last  two  decades
           Hepatocellular carcinoma (HCC) is the sixth most   because of improvements in patient evaluation, surgical
           common neoplasm and the third most frequent cause   technique, and perioperative care. Resection is the
           of cancer death in the world.  Because of the specific   ideal treatment, as it allows for complete removal and
                                    [1]
           characteristics of HCC, including its high recurrence   pathological confirmation of lesions. However, it is more
           rate and the frequent presence of chronic hepatitis and   invasive than other locoregional therapies such as
           cirrhosis, HCC treatment should focus on both curability   transarterial chemoembolization, tumor ablative therapy,
           and invasiveness.                                  and radiation therapy. [7-10]

           Liver resection is the preferable initial treatment option for   Laparoscopy has been used extensively and continues to
           solitary or limited multifocal HCCs with no extrahepatic   improve as a surgical option. Laparoscopic liver resection

                                                                                              Quick Response Code:
                       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.


            For reprints contact: service@oaepublish.com

                        © 2016 OAE Publishing Inc.  www.oaepublish.com                                    241
   8   9   10   11   12   13   14   15   16   17   18