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ホンダ ゴロウ
HONDA Gorou
本田 五郎 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Laparoscopic hepatectomy is feasible for patients diagnosed with hepatocellular carcinoma and cirrhotic liver |
| 掲載誌名 | 正式名：World journal of gastrointestinal surgery 略 称：World J Gastrointest Surg ISSNコード：19489366 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 18(1),pp.114262 |
| 著者・共著者 | Krerkrit Kijpongpans, ARIIZUMI Shunichi, OME Yusuke, KAWAMOTO Yusuke, MATSUNAGA Yutaro, HONDA Goro |
| 担当区分 | 最終著者,責任著者 |
| 発行年月 | 2026/01 |
| 概要 | BACKGROUND:Hepatocellular carcinoma (HCC) commonly arises in cirrhotic livers. Laparoscopic hepatectomy (LH) has shown promising outcomes, but its safety in moderate liver dysfunction remains unclear. Despite comparable surgical indications for LH and open hepatectomy (OH), data on impaired liver function are scarce. The Japanese Liver Damage Grading System (LDGS), incorporating indocyanine green retention at 15 min, provides a precise functional assessment.AIM:To compare short-term and long-term outcomes of LH and OH in patients with HCC LDGS grade B or C.METHODS:The 97 patients with HCC and LDGS grade B or C who underwent hepatectomy (26 LH; 71 OH) between 2010 and 2022 at Tokyo Women's Medical University Hospital were retrospectively analyzed. Propensity score matching (1:1) was applied. Baseline biochemical and tumor characteristics were compared. Short-term and long-term outcomes were assessed.RESULTS:Before matching patients who underwent LH had smaller tumors (2.7 cm vs 4.5 cm, P = 0.004) and lower surgical difficulty scores (P < 0.001). After matching LH was associated with lower intraoperative blood loss (242 mL vs 941 mL; P = 0.049), reduced postoperative ascites (0% vs 21.2%; P = 0.035), and shorter hospital stay with no conversion to OH. The 5-year overall survival rate was significantly higher in the LH group (91% vs 36%; P = 0.021) while recurrence-free survival was comparable.CONCLUSION:LDGS provides a comprehensive assessment of surgical candidates with moderate cirrhosis. In patients with HCC and grade B or C liver damage, LH appears to have better long-term outcomes than OH due to reduced morbidity and preservation of liver function. |
| DOI | 10.4240/wjgs.v18.i1.114262 |
| PMID | 41695877 |