Safety and efficacy of laparoscopic portal territory fluorescence navigation-guided anatomical liver resection in hepatocellular carcinoma patients
- 06.03.2025
Erschienen in:
- Verfasst von
- An-Zhi Wang
- Rui Zhou
- Jie Chen
- Fan Zhang
- Jing-Yang Du
- Ya-Jin Chen
- Jun Cao
- Erschienen in
- Surgical Endoscopy | Ausgabe 4/2025
Abstract
Background
The clinical effectiveness of classic anatomical resection (CAR) of the liver for hepatocellular carcinoma (HCC) has been controversial. Laparoscopic Portal Territory fluorescence navigation-guided anatomical liver resection (LPTAR) has been increasingly applied in clinical practice. However, evidence on the safety and efficacy of LPTAR is lacking.
Methods
A retrospective cohort study of patients who underwent laparoscopic hepatectomy from December 2018 to December 2022 was conducted. Propensity score matching (PSM) was employed to match patients who underwent LPTAR with patients who underwent CAR. Differences in recurrence-free survival (RFS), overall survival (OS), and perioperative data were evaluated between the LPTAR and CAR groups. Cox regression models were used for univariate and multivariate analyses, as well as subgroup analyses.
Results
Of the 234 patients included in this study, 70 underwent LRTAR, and 164 underwent CAR. After 1:1 PSM, each group contained 59 patients, and perioperative parameters were better in the LPTAR group. Specifically, the LPTAR group had wider resection margins (13.00 cm vs. 11.00 cm, P = 0.023), less blood loss (200 ml vs. 320 ml, P = 0.010), and fewer postoperative complications (33.90% vs. 57.62%, P = 0.016) than did the CAR group. The RFS rates of patients with HCC was also increased by LPTAR. The 1-, 3-, and 5-year RFS rates of the LPTAR group were significantly higher than those of the CAR group (P = 0.002).
Conclusion
Accurate preoperative planning and standardized LPTAR technical criteria prolonged RFS in HCC patients, improved the safety of surgery, and reduced surgical stress.
Trail registration: The study has been prospective registered at Chinese Clinical Trial Registry (https://www.chictr.org.cn/, ChiCTR2400087661).
Graphical abstract
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- Titel
- Safety and efficacy of laparoscopic portal territory fluorescence navigation-guided anatomical liver resection in hepatocellular carcinoma patients
- Verfasst von
-
An-Zhi Wang
Rui Zhou
Jie Chen
Fan Zhang
Jing-Yang Du
Ya-Jin Chen
Jun Cao
- Publikationsdatum
- 06.03.2025
- Verlag
- Springer US
- Erschienen in
-
Surgical Endoscopy / Ausgabe 4/2025
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218 - DOI
- https://doi.org/10.1007/s00464-025-11632-5
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