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Laparoscopic anatomical versus non-anatomical liver resection for hepatocellular carcinoma in the posterosuperior segments:a propensity score matched analysis

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 824-834,I0001页

作者： Boram Lee Jai Young Cho Ho-Seong Han Yoo-Seok Yoon Hae Won Lee Jun Suh Lee Moonhwan Kim yeongsoo jo Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnamKorea

Background:Since laparoscopic anatomical resection(LAR)for tumors,especially located in the posterosuperior(PS)segments of the liver remains difficult,laparoscopic non-anatomical resection(LNAR)are generally *** compare the clinical outcomes between LAR and LNAR for hepatocellular carcinoma(HCC)located in the PS ***:We retrospectively reviewed the data for 1,029 patients who underwent hepatectomy for HCC between 2004 and *** 167 patients who underwent laparoscopic hepatectomy for HCC in PS segments,64 underwent LNAR and 103 underwent *** were matched one-to-one using propensity score matching(46:46).Results:LNAR was associated with significantly shorter operation time(P=0.001),lower estimated blood loss(P=0.001),lower transfusion rate(P=0.006)and shorter hospital stay(P=0.012)than *** respective 1-,3-,and 5-year overall survival rates(LAR:95.3%,87.1%,and 77.8%;LNAR:96.7%,91.6%,and 85.0%;P=0.262)and recurrence-free survival rates(LAR:75.7%,70.3%,and 68.9%;LNAR:81.8%,58.3%,and 55.3%;P=0.879)were *** intrahepatic recurrence rate was significantly higher in LNAR group than in LAR group(78.6%vs.57.1%,P=0.023),but the post-recurrence treatments differed significantly between the two groups(P=0.016);the re-resection rate was much greater in the LNAR group(45.0%vs.0%)*** respective 1-,3-,and 5-year post-recurrence survival rates were similar in the LAR and LNAR groups(P=0.212).After recurrence,survival in re-resection group was significantly greater than not(P=0.026).Conclusions:LNAR is safe and feasible for HCC located in PS segments,and provided acceptable oncologic outcomes that are comparable to those of *** can be considered for patient with tumor located in PS segment when LAR is not feasible.

关键词： Laparoscopy hepatectomy carcinoma,hepatocellular recurrence

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Intra-arterial lipo-prostaglandin E1 infusion for arterial spasm in liver transplantation:A case report

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World journal of Clinical Cases 2023年第34期11卷 8153-8157页

作者： Moonhwan Kim Hae Won Lee Chang Jin Yoon Boram Lee yeongsoo jo Jai Young Cho Yoo-Seok Yoon Jun Suh Lee Ho-Seong Han Department of Surgery Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam-si 13620Gyeonggi-doSouth Korea Department of Radiology Seoul National UniversitySeongnam 463-707South Korea

BACKGROUND Hepatic artery obstruction is a critical consideration in graft outcomes after living donor liver *** report a case of diffuse arterial vasospasm that developed immediately after anastomosis and was managed with an intra-arterial infusion of lipo-prostaglandin E1(PGE1).CASE SUMMARY A 57-year-old male with hepatitis B virus-related liver cirrhosis and hepatocellular carcinoma underwent ABO-incompatible living donor liver *** grafted hepatic artery was first anastomosed to the recipient’s right hepatic artery ***,the arterial pulse immediately *** a new anastomosis was performed using the right gastroepiploic artery,the patient’s arterial pulse rate remained *** attempted angiographic intervention immediately after the operation;it showed diffuse arterial vasospasms like‘beads on a string’.We attempted continuous infusion of lipo-PGE1 overnight via an intra-arterial *** next day,arterial flow improved without any spasms or *** patient had no additional arterial complications or related sequelae at the time of writing,1-year post-liver *** Angiographic evaluation is helpful in cases of repetitive arterial obstruction,and intra-arterial infusion of lipo-PGE1 may be effective in treating diffuse arterial spasms.

关键词： Liver transplantation Hepatic artery Vasospasm Prostaglandin E1 Intervention Case report

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