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Role of surgical resection for multiple hepatocellular carcinomas

World Journal of Gastroenterology 2013年第3期19卷 366-374页

作者： Sung Hoon choi gi hong choi Seung Up Kim Jun Yong Park Dong Jin Joo Man Ki Ju Myoung Soo Kim Jin Sub choi Kwang Hyub Han Soon Il Kim Department of Surgery Yonsei University College of MedicineSeoul 120-752South Korea Department of Internal Medicine Yonsei University College of MedicineSeoul 120-752South Korea

AIM:To clarify the role of surgical resection for multiple hepatocellular carcinomas(HCCs)compared to transarterial chemoembolization(TACE)and liver transplantation(LT). METHODS:Among the HCC patients who were managed at Yonsei University Health System between January 2003 and December 2008,160 patients who met the following criteria were retrospectively enrolled:(1) two or three radiologically diagnosed HCCs;(2)no radiologic vascular invasion;(3)Child-Pugh class A;(4) main tumor smaller than 5 cm in diameter;and(5) platelet count greater than 50 000/***-term outcomes were compared among the following three treatment modalities:surgical resection or combined radiofrequency ablation(RFA)(n=36),TACE(n=107), and LT(n=17).The survival curves were computed using the Kaplan-Meier method and compared with a log-rank *** identify the patients who gained a survival benefit from surgical resection,we also investigated prognostic factors for survival following surgical *** analyses of the prognostic factors for survival were performed using the Cox proportional hazard model. RESULTS:The overall survival(OS)rate was significantly higher in the surgical resection group than in the TACE group(48.1%vs 28.9%at 5 years,Pgical resection group,although the difference was not statistically significant(80.2%vs 48.1%at 5 years,P=0.447).The disease-free survival rates were also significantly higher in the LT group than in the surgical resection group(88.2%vs 11.2%at 5 years, Pgical resection. Clinical liver cirrhosis rates were 55.6%(20/36)in the resection group and 93.5%(100/107)in the TACE *** were 19 major and 17 minor resections. En bloc resection was performed in 23 patients,multisite resection was performed in 5 patients,and combined resection with RFA was performed in 8 patients. In the TACE

关键词： Hepatocellular carcinoma Hepatectomy Liver transplantation Chemoembolization Cirrhosis

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Two distinct stem cell-like subtypes of hepatocellular carcinoma with clinical significance and their therapeutic potentials

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Cancer Communications 2022年第2期42卷 179-183页

作者： Sung Hwan Lee Yun Seong Jeong Sunyoung Lee Bo Hwa Sohn Ho Kyoung Hwang gi hong choi Chang Moo Kang Jin Sub choi Woo Jung Lee Jae-Ho Cheong Hee Jin Jang Ahmed Kaseb Lewis Roberts Sun Young Yim Yun Shin Chun Ju-Seog Lee Department of Systems Biology the University of Texas MD Anderson Cancer CenterHoustonTX 77030USA Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryYonsei University College of MedicineSeoul 03722Republic of Korea Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryCHA Bundang Medical CenterCHA UniversitySeongnam 13496Republic of Korea Department of gi Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTX 77030USA Department of Surgery Yonsei University Health SystemYonsei University College of MedicineSeoul 03722Republic of Korea Division of Thoracic Surgery Michael E.DeBakey Department of SurgeryBaylor College of MedicineHoustonTX 77030USA Division of Gastroenterology and Hepatology Mayo ClinicRochesterMN 55902USA Division of Gastroenterology and Hepatology Department of Internal MedicineKorea University College of MedicineSeoul 02841Republic of Korea Department of Surgery The University of Texas MD Anderson Cancer CenterHoustonTX 77030USA

Dear Editor Hepatocellular carcinoma(HCC)is among the most com-mon cancers worldwide,causing about 600,000 deaths annully[1].In HCC,stem cell-like characteristics,which drive early recurrence and therapy resistance,are major contributors to poor prognosis[2].In this current study,we integrated and analyzed gene expression data from human fetal liver cells and primary HCC tumors(n=1231)*** two clinically and biologically distinct hepatic stem cell(HS)subtypes,potential biomarkers associated with these subtypes,and a potential new therapeutic inter-vention for these subtypes.

关键词： therapeutic subtypes prognosis

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International consensus statement on robotic hepatectomy surgery in 2018

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World Journal of Gastroenterology 2019年第12期25卷 1432-1444页

作者： Rong Liu Go Wakabayashi hong-Jin Kim gi-hong choi Anusak Yiengpruksawan Yuman Fong Jin He Ugo Boggi Roberto I Troisi Mikhail Efanov Daniel Azoulay Fabrizio Panaro Patrick Pessaux Xiao-Ying Wang Ji-Ye Zhu Shao-Geng Zhang Chuan-Dong Sun Zheng Wu Kai-Shan Tao Ke-Hu Yang Jia Fan Xiao-Ping Chen Second Department of Hepatopancreatobiliary Surgery Chinese People’s Liberation Army (PLA) General Hospital Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases Ageo Central General Hospital Department of Surgery Yeungnam University Hospital Division of Hepatobiliary Pancreatic Surgery Department of Surgery Yonsei University College of Medicine Minimally Invasive Surgery Division Department of SurgeryFaculty of Medicine Siriraj Hospital Mahidol University Department of Surgery City of Hope Medical Center Department of Surgery the Johns Hopkins Hospital Division of General and Transplant Surgery Pisa University Hospital Department of Clinical Medicine and Surgery Federico II University Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific Center Hepato-Biliary Center Paul Brousse University Hospital Hepato-Biliary Center Tel Hashomer University Hospital Department of Surgery/Division of HBP Surgery and Transplantation Montpellier University Hospital-School of Medicine Head of the Hepato-biliary and pancreatic surgical unit Nouvel Hopital Civil Department of Liver Surgery and Transplantation Liver Cancer Institute Zhongshan Hospital Fudan University Department of Hepatobiliary Surgery Peking University People’s Hospital Department of Hepatobiliary Surgery 302 Hospital of Chinese PLA Department of Hepatobiliary and Pancreatic Surgery the Affiliated Hospital of Qingdao University Department of Hepatobiliary Surgery the First Affiliated Hospital of Xi’an Jiaotong University Department of Hepatobiliary Surgery Xijing Hospital the Fourth Military Medical University Evidence Based Medicine Center School of Basic Medical Sciences Lanzhou University Hepatic Surgery Center Tongji Hospital Tongji Medical College Huazhong University of Science and Technology

The robotic surgical system has been applied in liver surgery. However,controversies concerns exist regarding a variety of factors including the safety,feasibility, efficacy, and cost-effectiveness of robotic surgery. To promote the development of robotic hepatectomy, this study aimed to evaluate the current status of robotic hepatectomy and provide sixty experts' consensus and recommendations to promote its development. Based on the World Health Organization Handbook for Guideline Development, a Consensus Steering Group and a Consensus Development Group were established to determine the topics, prepare evidence-based documents, and generate recommendations. The GRADE Grid method and Delphi vote were used to formulate the recommendations. A total of 22 topics were prepared analyzed and widely discussed during the 4 meetings. Based on the published articles and expert panel opinion, 7 recommendations were generated by the GRADE method using an evidence-based method, which focused on the safety, feasibility, indication,techniques and cost-effectiveness of hepatectomy. given that the current evidences were low to very low as evaluated by the GRADE method, further randomized-controlled trials are needed in the future to validate these recommendations.

关键词： Minimally invasive surgery Robotic hepatectomy Laparoscopic hepatectomy Hepatectomy resection Consensus statement

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Minimally invasive liver resection for huge(≥10cm)tumors:an international multicenter matched cohort study with regression discontinuity analyses

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Hepatobiliary Surgery and Nutrition 2021年第5期10卷 587-597,I0001-I0003页

作者： Tan-To Cheung Xiaoying Wang Mikhail Efanov Rong Liu David Fuks gi-hong choi Nicholas LSyn Charing CChong Iswanto Sucandy Adrian KHChiow Marco VMarino Mikel Gastaca Jae Hoon Lee TPeter Kingham Mathieu D’Hondt Sung Hoon choi Robert PSutcliffe Ho-Seong Han Chung Ngai Tang Johann Pratschke Roberto ITroisi Brian KPGoh International Robotic and Laparoscopic Liver Resection Study Group Collaborators Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of Digestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance Division of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongNew TerritoriesHong KongChina AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General HospitalSingaporeSingapore General Surgery Department Azienda Ospedaliera Ospedali Riuniti Villa Sofia-CervelloPalermoItaly Oncologic Surgery Department P.Giaccone University HospitalPalermoItaly Hepatobiliary Surgery and Liver Transplantation Unit Biocruces Bizkaia Health Research InstituteCruces University HospitalUniversity of the Basque CountryBilbaoSpain Department of Surgery Division of Hepato-Biliary and Pancreatic SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea Department of Surgery Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA Department of Digestive and Hepatobiliary/Pancreatic Surgery Groeninge HospitalKortrijkBelgium Department of General Surgery CHA Bundang Medical CenterCHA University School of MedicineSeongnamKorea Department of Hepatopancreatobiliary and Liver Transplant Surgery University Ho

Background:The application and feasibility of minimally invasive liver resection(MILR)for huge liver tumours(≥10 cm)has not been well ***:Retrospective analysis of data on 6,617 patients who had MILR for liver tumours were gathered from 21 international centers between *** tumors and large tumors were defined as tumors with a size≥10.0 cm and 3.0-9.9 cm based on histology,respectively.1:1 coarsened exact-matching(CEM)and 1:2 Mahalanobis distance-matching(MDM)was performed according to clinically-selected *** discontinuity analyses were performed as an additional line of sensitivity analysis to estimate local treatment effects at the 10-cm tumor size ***:Of 2,890 patients with tumours≥3 cm,there were 205 huge *** 1:1 CEM,174 huge tumors were matched to 174 large tumors;and after 1:2 MDM,190 huge tumours were matched to 380 large *** was significantly and consistently increased intraoperative blood loss,frequency in the application of Pringle maneuver,major morbidity and postoperative stay in the huge tumour group compared to the large tumour group after both 1:1 CEM and 1:2 *** findings were reinforced in RD *** blood transfusion rate and open conversion rate were significantly higher in the huge tumor group after only 1:2 MDM but not 1:1 ***:MILR for huge tumours can be safely performed in expert centers It is an operation with substantial complexity and high technical requirement,with worse perioperative outcomes compared to MILR for large tumors,therefore judicious patient selection is pivotal.

关键词： Minimally invasive liver resection(MILR) robotic-assisted liver resection huge tumours hepatocellular carcinoma laparoscopic liver resection

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International experts consensus guidelines on robotic liver resection in 2023

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World Journal of Gastroenterology 2023年第32期29卷 4815-4830页

作者： Rong Liu Mohammed Abu Hilal Go Wakabayashi Ho-Seong Han Chinnusamy Palanivelu Ugo Boggi Thilo Hackert hong-Jin Kim Xiao-Ying Wang Ming-Gen Hu gi hong choi Fabrizio Panaro Jin He Mikhail Efanov Xiao-Yu Yin Roland S Croner Yu-Man Fong Ji-Ye Zhu Zheng Wu Chuan-Dong Sun Jae Hoon Lee Marco V Marino Iyer Shridhar Ganpati Peng Zhu Zi-Zheng Wang Ke-Hu Yang Jia Fan Xiao-Ping Chen Wan Yee Lau Faculty of Hepato-Pancreato-Biliary Surgery The First Medical Center of Chinese PLA General HospitalBeijing 100000China Hepatobiliary Pancreatic Robotic&Laparoscopic SurgeryPoliambulanza Foundation HospitalBrescia 25100Italy Center for Advanced Treatment of HBP Diseases Ageo Central General HospitalSaitama 362-0075Japan Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeoul 03080South Korea GEM Hospital&Research Centre GEM Hospital&Research CentreCoimbatore 641045India Division of General and Transplant Surgery University of PisaPisa 56126Italy Department of General Visceral and Thoracic SurgeryUniversity Hospital Hamburg-EppendorfHamburg 20251Germany Department of Surgery Yeungnam University HospitalDaegu 42415South Korea Department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghai 200032China Division of Hepato-Biliary-Pancreatic Surgery Department of SurgerySeverance HospitalYonsei UniversityCollege of MedicineSeoul 03722South Korea Department of Surgery/Division of Robotic and HBP Surgery Montpellier University Hospital-School of MedicineMontpellier 34090France Department of Surgery Johns Hopkins University School of MedicineBaltimoreMD 21218United States Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscow 111123Russia Department of Pancreatobiliary Surgery The First Affiliated HospitalSun Yat-Sen UniversityGuangzhou 510080Guangdong ProvinceChina Department of General VisceralVascular and Transplant SurgeryUniversity Hospital MagdeburgMagdeburg 39120Germany Department of Surgery City of Hope Medical CenterDuarteCA 91010United States Department of Hepatobiliary Surgery Peking University People’s HospitalBeijing 100000China Department of Hepatobiliary Surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’an 710061Shaanxi ProvinceChina Department of Hepatobiliary and Pancreatic Surgery The Affiliated Ho

The robotic liver resection(RLR)has been increasingly applied in recent years and its benefits shown in some aspects owing to the technical advancement of robotic surgical system,however,controversies still *** on the foundation of the previous consensus statement,this new consensus document aimed to update clinical recommendations and provide guidance to improve the outcomes of RLR clinical *** guideline steering group and guideline expert group were formed by 29 international experts of liver surgery and evidence-based medicine(EBM).Relevant literature was reviewed and analyzed by the evidence evaluation *** to the WHO Handbook for Guideline Development,the Guidance Principles of Development and Amendment of the Guidelines for Clinical Diagnosis and Treatment in China 2022,a total of 14 recommendations were *** them were 8 recommendations formulated by the GRADE method,and the remaining 6 recommendations were formulated based on literature review and experts’opinion due to insufficient EBM *** international experts consensus guideline offered guidance for the safe and effective clinical practice and the research direction of RLR in future.

关键词： Robotic liver resection Laparoscopic liver resection Guidelines Expert consensus

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Machine Learning for QoS Optimization and Energy-Efficient in Routing Clustering Wireless Sensors

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Computers, Materials & Continua 2025年第1期82卷 327-343页

作者： Rahma Gantassi Zaki Masood Yonghoon choi Department of Electrical Engineering Chonnam National University Gwangju61186Republic of Korea

Wireless sensor network(WSN)technologies have advanced significantly in recent *** in WSNs,machine learning algorithms are crucial in selecting cluster heads(CHs)based on various quality of service(QoS)*** paper proposes a new clustering routing protocol employing the Traveling Salesman Problem(TSP)to locate the optimal path traversed by the Mobile Data Collector(MDC),in terms of energy and QoS *** bemore specific,to minimize energy consumption in the CH election stage,we have developed the M-T protocol using the K-Means and the grid clustering *** addition,to improve the transmission phase of the Low Energy Adaptive Clustering-Grid-KMeans(LEACH-G-K)protocol,the MDC is employed as an intermediary between the CH and the sink to improve the wireless sensor network(WSN)*** results of the experiment demonstrate that the M-T protocol enhances various Low Energy Adaptive Clustering protocol(LEACH)improvements such as the LEACH-G-K,LEACH-C,Threshold sensitive Energy Efficient Sensor Networks(TEEN),MDC maximum residual energy leach protocol.

关键词： LEACH-G-K MDC TSP QoS K-Means

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Therapeutic potential of exercise-hormone irisin in Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1555-1564页

作者： Eunhee Kim Rudolph ETanzi Se Hoon choi Genetics and Aging Research Unit MassGeneral Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolCharlestownMAUSA McCance Center for Brain Health Massachusetts General HospitalBostonMAUSA

Irisin is a myokine that is generated by cleavage of the membrane protein fibronectin type Ⅲ domain-containing protein 5(FNDC5) in response to physical exercise. Studies reveal that irisin/FNDC5 has neuroprotective functions against Alzheimer's disease, the most common form of dementia in the elderly, by improving cognitive function and reducing amyloid-β and tau pathologies as well as neuroinflammation in cell culture or animal models of Alzheimer's disease. Although current and ongoing studies on irisin/FNDC5 show promising results, further mechanistic studies are required to clarify its potential as a meaningful therapeutic target for alleviating Alzheimer's disease. We recently found that irisin treatment reduces amyloid-β pathology by increasing the activity/levels of amyloid-β-degrading enzyme neprilysin secreted from astrocytes. Herein, we present an overview of irisin/FNDC5's protective roles and mechanisms against Alzheimer's disease.

关键词： Alzheimer's disease exercise fibronectin typeⅢdomain-containing protein 5(FNDC5) irisin

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Apolipoprotein A-I binding protein-mediated neuroprotection in glaucomatous neuroinflammation and neurodegeneration

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Neural Regeneration Research 2025年第5期20卷 1414-1415页

作者： Sinwoo Hwang Seunghwan choi Soo-Ho choi Keun-Young Kim Yury I.Miller Won-Kyu Ju Hamilton Glaucoma Center and Shiley Eye Institute The Viterbi Family Department of OphthalmologyUniversity of California San DiegoLa JollaCAUSA Department of Medicine University of California San DiegoLa JollaCAUSA National Center for Microscopy and Imaging Research Department of NeurosciencesUniversity of California San DiegoLa JollaCAUSA

Glaucoma is a multifactorial eye disorder that can cause vision loss and irreversible blindness,affecting individ uals aged 40 to 80 yea rs *** to the aging population,it is expected that the number of people affected by glaucoma will surpass 111 million by 2040 as the disease becomes more *** primarily contributes to optic nerve axon loss and the progressive degeneration of retinal ganglion cells (RGCs),subsequently leading to vision impairment.

关键词： irreversible pass primarily

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Acute and chronic excitotoxicity in ischemic stroke and late-onset Alzheimer's disease

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Neural Regeneration Research 2025年第7期20卷 1981-1988页

作者： Shan Ping Yu Emily choi Michael QJiang Ling Wei Department of Anesthesiology Emory University School of MedicineAtlantaGAUSA Center for Visual and Neurocognitive Rehabilitation Atlanta Veterans Affairs Medical CenterDecaturGAUSA

Stroke and Alzheimer's disease are common neurological disorders and often occur in the same *** comorbidity of the two neurological disorders represents a grave health threat to older *** review presents a brief background of the development of novel concepts and their clinical *** activity of glutamatergic N-methyl-D-aspartate receptors and N-methyl-D-aspartate receptor-mediated Ca^(2+)influx is critical for neuronal *** ischemic insult induces prompt and excessive glutamate release and drastic increases of intracellular Ca^(2+)mainly via N-methyl-D-aspartate receptors,particularly of those at the extrasynaptic *** Ca^(2+)-evoked neuronal cell death in the ischemic core is dominated by necrosis within a few hours and days known as acute ***,mild but sustained Ca^(2+)increases under neurodegenerative conditions such as in the distant penumbra of the ischemic brain and early stages of Alzheimer's disease are not immediately toxic,but gradually set off deteriorating Ca^(2+)-dependent signals and neuronal cell loss mostly because of activation of programmed cell death *** on the Ca^(2+)hypothesis of Alzheimer's disease and recent advances,this Ca^(2+)-activated“silent”degenerative excitotoxicity evolves from years to decades and is recognized as a unique slow and chronic *** N-methyl-D-aspartate receptor subunit GluN3A,primarily at the extrasynaptic site,serves as a gatekeeper for the N-methyl-D-aspartate receptor activity and is neuroprotective against both acute and chronic *** stroke and Alzheimer's disease,therefore,share an N-methyl-D-aspartate receptor-and Ca^(2+)-mediated mechanism,although with much different time *** is thus proposed that early interventions to control Ca^(2+)homeostasis at the preclinical stage are pivotal for individuals who are susceptible to sporadic late-onset Alzheimer's disease and Alzheimer's disease-related

关键词： Ca^(2+)hypothesis cognitive deficits hyperactivity late-onset Alzheimer's disease neurodegeneration N-methyl-D-aspartate receptors N-methyl-D-aspartate receptor subunits pathogenesis preventive treatment

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Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases

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Hepatobiliary Surgery and Nutrition 2023年第2期12卷 205-215,I0005页

作者： Tan-To Cheung Rong Liu Federica Cipriani Xiaoying Wang Mikhail Efanov David Fuks gi-hong choi Nicholas L.Syn Charing C.N.Chong Fabrizio Di Benedetto Ricardo Robles-Campos Vincenzo Mazzaferro Fernando Rotellar Santiago Lopez-Ben James O.Park Alejandro Mejia Iswanto Sucandy Adrian K.H.Chiow Marco V.Marino Mikel Gastaca Jae Hoon Lee TPeter Kingham Mathieu D’Hondt Sung Hoon choi Robert P.Sutcliffe Ho-Seong Han Chung-Ngai Tang Johann Pratschke Roberto I.Troisi Go Wakabayashi Daniel Cherqui Felice giuliante Davit L.Aghayan Bjorn Edwin Olivier Scatton Atsushi Sugioka Tran Cong Duy Long Constantino Fondevila Mohammad Abu Hilal Andrea Ruzzenente Alessandro Ferrero Paulo Herman Kuo-Hsin Chen Luca Aldrighetti Brian K.P.Goh International robotic and laparoscopic liver resection study group investigators Department of Surgery Queen Mary HospitalThe University of Hong KongHong Kong SARChina Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Hepatobiliary Surgery Division IRCCS San Raffaele HospitalMilanItaly Department of Liver Surgery and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina Department of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Department of Digestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance Division of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina HPB Surgery and Liver Transplant Unit University of Modena and Reggio EmiliaModenaItaly Department of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de la ArrixacaIMIB-ARRIXACAMurciaSpain HPB Surgery Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly HPB and Liver Transplant Unit Department of General SurgeryClinica Universidad de NavarraUniversidad de NavarraPamplonaSpain Institute of Health Research of Navarra(IdisNA) PamplonaSpain Hepatobiliary and Pancreatic Surgery Unit Department of SurgeryDr.Josep Trueta HospitalIdIBGiGironaSpain Hepatobiliary Surgical Oncology Department of SurgeryUniversity of Washington Medical CenterSeattleWAUSA The Liver Institute Methodist Dallas Medical CenterDallasTXUSA AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General

Background:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A large scale international multicenter study would provide stronger evidence and insight into application of these techniques for huge liver tumours≥10 ***:This was a retrospective review of 971 patients who underwent LLR and RLR for huge(≥10 cm)tumors at 42 international centers between ***:One hundred RLR and 699 LLR which met study criteria were *** comparison between the 2 approaches for patients with huge tumors were performed using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated with significantly increased frequency of previous abdominal surgery,malignant pathology,liver cirrhosis and increased median *** PSM,RLR and LLR was associated with no significant difference in key perioperative outcomes including media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative length of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with huge liver tumours with excellent *** was no significant difference in perioperative outcomes after RLR or LLR.

关键词： Laparoscopic liver resection(LLR) robotic liver resection(RLR) hepatocellular carcinoma colorectal liver metastases huge

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