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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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