Standardized Technique for Minimally Invasive Right Posterior Sectionectomy for Hepatocellular Carcinoma: A...

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Minimally Invasive Procedures

Background:

• Hepatocellular carcinoma (HCC) treatment often involves anatomical liver resections.
• Minimally invasive right posterior sectionectomy (MIRPS) is a complex procedure with uncertain outcomes compared to open surgery.
• Evaluating MIRPS against open right posterior sectionectomy (ORPS) is crucial for HCC management.

Purpose of the Study:

• To compare perioperative outcomes between MIRPS and ORPS for HCC.
• To assess long-term oncological results of MIRPS versus ORPS in HCC patients.
• To determine the safety and feasibility of MIRPS for selected HCC cases.

Main Methods:

• Retrospective analysis of 122 patients undergoing right posterior sectionectomy for primary HCC.
• Comparison of MIRPS and ORPS groups using 1:1 propensity score matching (PSM).
• Evaluation of surgical outcomes, including blood loss, transfusion rates, operative time, morbidity, and hospital stay.

Main Results:

• MIRPS group (35 patients) showed significantly less blood loss (119 vs. 548 ml) and lower morbidity (0% vs. 28.6%) than ORPS group (35 patients).
• MIRPS resulted in shorter operative times (356 vs. 396 min) and hospital stays (9 vs. 15 days) with no conversions to open surgery.
• Survival rates (overall and recurrence-free) were comparable between MIRPS and ORPS groups at 1, 3, and 5 years.

Conclusions:

• MIRPS for HCC significantly reduces perioperative complications and hospital stay compared to ORPS.
• The oncological outcomes, including survival rates, are comparable between MIRPS and ORPS.
• Standardized MIRPS is a safe, feasible, and oncologically acceptable option for selected HCC patients.