Abstract
Background
Widespread use of minimally invasive liver surgery (MILS) contributed to the reduction
of surgical risk of liver resection for hepatocellular carcinoma (HCC). Aim of this
study was to analyze outcomes of MILS for single ≤3 cm HCC.
Methods
Patients who underwent MILS for single ≤3 cm HCC (November 2014 - December 2019) were
identified from the Italian Group of Minimally Invasive Liver Surgery (IGoMILS) Registry.
Results
Of 714 patients included, 641 (93.0%) were Child-Pugh A; 65.7% were limited resections
and 2.2% major resections, with a conversion rate of 5.2%. Ninety-day mortality rate
was 0.3%. Overall morbidity rate was 22.4% (3.8% major complications). Mean postoperative
stay was 5 days. Robotic resection showed longer operative time (p = 0.004) and a higher overall morbidity rate (p < 0.001), with similar major complications (p = 0.431). Child-Pugh B patients showed
worse mortality (p = 0.017) and overall morbidity (p = 0.021), and longer postoperative stay (p = 0.005). Five-year overall survival was 79.5%; cirrhosis, satellite micronodules,
and microvascular invasion were independently associated with survival.
Conclusions
MILS for ≤3 cm HCC was associated with low morbidity and mortality rates, showing
high safety, and supporting the increasing indications for surgical resection in these
patients.
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Article info
Publication history
Published online: February 23, 2023
Accepted:
February 10,
2023
Received:
September 22,
2022
Publication stage
In Press Corrected ProofFootnotes
The paper was presented at the 14th IHPBA World Congress, Virtual Congress, November 27–29, 2020.
SYNOPSIS: minimally invasive liver resection for small single HCC ≤3 cm is associated with reduced morbidity and mortality rates with significant improvement of safety.
Identification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
