Recurrent Liver Cancer Patients Can Also Undergo Laparoscopic Surgery
The transplant research team at Liver Cancer Center (SMC) revealed that laparoscopic surgery is possible even though the initial surgery was a laparotomy, in cases where the size of the recurrent liver tumor is 3 cm or less, and the recurrence site is on the opposite side of the initial onset site.
Specialists from the liver cancer center analyzed 50 patients who needed surgery because of recurrent liver cancer between 2017 and 2019. The results were reported in the international journal of surgery, Updates in Surgery.
In the past, laparotomy was generally performed because previous treatment was likely to result in liver morphology deformation or stenosis around the surgery site and because it was the safer option for patients.
The research teams assigned 25 patients to laparoscopy surgery and 25 to laparotomy. The patients’ characteristics and prognosis were then compared and analyzed by applying IPTW.
The average age of the subjects was around 61; there were no differences between subjects on factors such as the severity of cancer stage or microvascular infiltration, portal vein infiltration, and cirrhosis that can affect surgery results, respectively. Notably, the tumor size of patients who received laparotomy (1.9 cm) was relatively larger than those of patients who received laparoscopic surgery (1.5 cm).
According to the research team, tracking the total survival rate for approximately three years for patients who received laparoscopic surgery and patients who received laparotomy does not show any significant differences between the two groups. However, when the non-progressed survival period was analyzed separately, patients with laparoscopy showed a much better score than patients with laparotomy.
The average hospital stay for patients with laparoscopy was 5.5 days, which was shorter than that of the patients with laparotomy (9.3 days), indicating a faster recovery rate for the patients with laparoscopy. Though not statistically significant, the surgery time for laparoscopy was, on average, 125 minutes, which was about 40 minutes shorter than that of the laparotomy (168 minutes). Bleeding during surgery was also less in laparoscopy (140 ml) compared to laparotomy (212 ml).
Professor Jong Man Kim, who is the corresponding author of this research, said, “Because of the small sample number of subjects for the study, there is a need to accumulate further data to fine-tune target groups, but it is meaningful in that criteria for presenting which patients would benefit became available,” and that “we will put our efforts into upgrading the technology so that more patients with recurrent liver cancer can also receive laparoscopic surgery with less burden.”