Detailed Abstract
[Liver Oral Presentation 4]
[LV OP 4-2] Repeat minimally invasive liver resection for hepatocellular carcinoma: analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry.
Giovanni Battista LEVI SANDRI*1, Luca ALDRIGHETTI2, Alfredo GUGLIELMI3, Umberto CILLO4, Vincenzo MAZZAFERRO5, Raffaele DALLA VALLE6, Luciano DE CARLIS7, Salvatore GRUTTADAURIA8, Fabrizio DI BENEDETTO9, Alessandro FERRERO10, Giuseppe Maria ETTORRE1
1Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Italy
2Hepatobiliary Surgery, IRCCS San Raffaele Hospital, Milan, Italy
3Department of Hepatobiliary Surgery, G.B. Rossi Hospital, University of Verona, Italy
4Department of Surgery, Oncology and Gastroenterology, University of Padua, Italy
5HPB Surgery and Liver Transplantation, Department of Surgery, University of Milan, Italy
6Department of Surgery, Parma University Hospital, Italy
7Surgical and Transplant Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
8Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, Mediterranean Institute for Transplantation and Specialization Therapies (IRCCS-ISMETT), Palermo, Italy
9Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Italy
10Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, Turin, Italy
Introduction : Minimally invasive liver surgery (MILS) for HCC is a safe procedure. Redo surgery (ReS) is often required, and the role of MILS is not clearly defined. The prime endpoint of the study is to compare ReS with first surgery cases. The secondary endpoint is to evaluate the outcome of ReS in case of primary open versus MILS surgery.
Methods : We divided the cohort into two groups, Group 1: first liver resection and Group 2: ReS. A first Propensity Score Matching analysis was performed to compare the two groups, and an ulterior sub-analysis comparing open versus MILS primary resection in the ReS group was achieved.
Results : One thousand fifty-four cases were included in this study from 52 Centers. Eighty cases were ReS. The first hepatic surgery were: 43 wedge resection, 26 segmentectomies, 3 left lateral sectionectomy, 3 right posterior sectionectomy, 4 major resections, and one liver transplant. Type of redo resection were: 51 wedge resection, 18 segmentectomies, 3 left lateral sectionectomy, 2 bi-segmentectomy, 4 left hepatectomy and 1 right hepatectomy. No difference was observed before and after PSM between the primary versus redo surgery regarding the operative data: type of resection, surgical time, blood loss, morbidity, conversion rate, and length of stay. In the ReS, 44 patients had previous open resection, and 36 had MILS. No difference in the morbidity of ReS between this two sub-group.
Conclusions : According to our results, repeat surgery with a MILS approach is feasible and safe for HCC even when a previous open resection was performed.
Methods : We divided the cohort into two groups, Group 1: first liver resection and Group 2: ReS. A first Propensity Score Matching analysis was performed to compare the two groups, and an ulterior sub-analysis comparing open versus MILS primary resection in the ReS group was achieved.
Results : One thousand fifty-four cases were included in this study from 52 Centers. Eighty cases were ReS. The first hepatic surgery were: 43 wedge resection, 26 segmentectomies, 3 left lateral sectionectomy, 3 right posterior sectionectomy, 4 major resections, and one liver transplant. Type of redo resection were: 51 wedge resection, 18 segmentectomies, 3 left lateral sectionectomy, 2 bi-segmentectomy, 4 left hepatectomy and 1 right hepatectomy. No difference was observed before and after PSM between the primary versus redo surgery regarding the operative data: type of resection, surgical time, blood loss, morbidity, conversion rate, and length of stay. In the ReS, 44 patients had previous open resection, and 36 had MILS. No difference in the morbidity of ReS between this two sub-group.
Conclusions : According to our results, repeat surgery with a MILS approach is feasible and safe for HCC even when a previous open resection was performed.
SESSION
Liver Oral Presentation 4
Room A 7/29/2020 8:20 AM - 8:30 AM