Benefits of a modified local precision liver resection using intraoperative laparoscopic ultrasound in the treatment and prognosis of patients with liver cancer.
Beneficios de la resección hepática de precisión local modificada, utilizando ecografía intraoperatoria laparoscópica en el tratamiento y pronóstico de pacientes con cáncer de hígado.
Keywords:
precision hepatectomy, liver function, hepatic venous injury, immune factors, immune response, cytokines, Karnofsky performance scale
Abstract
The incidence and mortality rate of liver cancer has increased significantly. Recently, intraoperative laparoscopic ultrasound (LUS) has been used in hepatectomy, in addition to open liver resection, as the most common treatment method. The current research aims to address this issue. Seventy-six patients with liver cancer who were admitted to the Hospital of Beihua University from February 2018 to September 2021 were randomly divided into two groups of 38 patients, one group undergoing conventional laparoscopic surgery (control group) and the other group undergoing a precise laparoscopic liver resection after placing an intraoperative LUS instrument (study group). Blood loss and hepatic vein damage during surgery were less in the study group (p<0.05). Seven days after surgery, liver function indices (albumin, total bilirubin, and alanine and aspartate aminotransferases) and indices related to immune function interleukin 6, tumor necrosis factor α, CD3+ and CD4+ T lymphocytes and NK cells level in the study group improved compared to the control group. The postoperative complications were less in the study group, and the nine-month follow-up showed that the recurrence rate was lower and the survival rate was higher in this group. This study shows that precise laparoscopic hepatectomy modified with the use of intraoperative laparoscopic ultrasound results in better intraoperative and postoperative outcomes for the prognosis and survival rate of patients with liver cancer, which makes this surgical technique worth generalizing in clinical practice.
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References
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Shannon AH, Ruff SM, Pawlik TM. Expert insights on current treatments for hepato-cellular carcinoma: clinical and molecular approaches and bottlenecks to progress. J Hepatocell Carcinoma 2022; 9:1247-1261. https://doi.org/10.2147/JHC.S383922.
Boudjema K, Locher C, Sabbagh C, Ortega-Deballon P, Heyd B, Bachellier P, Metairie S, Paye F, Bourlier P, Adam R, Merdrignac A, Tual Ch, Pabic E L, Sulpice L, Meunier B, Regimbeau J-M, Bellissant E. Simultaneous versus delayed resection for initially resectable synchronous colorectal cancer liver metastases: A prospective, open-label, randomized, controlled trial. Ann Surg 2021;273(1):49-56. https://doi. org/10.1097/SLA.0000000000003848.
Aliseda D, Martí-Cruchaga P, Zozaya G, Rodríguez-Fraile M, Bilbao JI, Benito- Boillos A, De La Cuesta AM, Lopez- Olaondo L, Hidalgo F, Ponz-Sarvisé M, Chopitea A, Rodríguez J, Iñarrairaegui M, Herrero J I, Pardo F, Sangro B, Rotellar F. Liver resection and transplantation following Yttrium-90 radioembolization for primary malignant liver tumors: A 15- year single-center experience. Cancers 2023;15(3):733. https://doi.org/10.3390/ cancers15030733.
Naidu CS, Sarin A. Postoperative liver failure. GI Surgery Annual 2017;23:59-81.
Hou H, Zhou D, Cui X, Wang L, Wu C, Xiong Q, Geng X. Laparoscopic liver resection ameliorates the postoperative liver function impairment for hepatocellular carcinoma patients. Surg Laparosc Endosc Percutan Tech. 2020;30(1):69-73. https://doi. org/10.1097/SLE.0000000000000749.
Kuemmerli C, Fichtinger RS, Moekotte A, Aldrighetti LA, Aroori S, Besselink MGH, D’Hondt M, Díaz-Nieto R, Edwin B, Efanov M, M. Ettorre G, Menon K V, Sheen A J, Soonawalla Z, Sutcliffe R, Troisi R I, White SA, Brandts L, van Breukelen GJP, Sijberden J, Pugh SA, Eminton Z, Primrose JN, Dam RV. Laparoscopic versus open resections in the posterosuperior liver segments within an enhanced recovery programme (ORANGE Segments): study protocol for a multicentre randomised controlled trial. Trials 2022;23(1):206. https://doi.org/10.1186/ s13063-022-06112-3.
Zhang W, Zhu W, Yang J, Xiang N, Zeng N, Hu H, Jia F, Fang Ch. Augmented reality navigation for stereoscopic laparoscopic anatomical hepatectomy of primary liver cancer: Preliminary experience. Front Oncol 2021;11:663236. https://doi. org/10.3389/fonc.2021.663236.
Lam J, Tam MS, Retting RL, McLemore EC. Robotic versus laparoscopic surgery for rectal cancer: A comprehensive review of oncological outcomes. Perm J 2021;25. https://doi.org/10.7812/TPP/21.050.
Serednicki W, Hołówko W, Major P, Małczak P, Pędziwiatr M. Minimizing blood loss and transfusion rate in laparoscopic liver surgery: a review. Videosurgery and other miniinvasive techniques 2023;18(2):213-223. https://doi.org/10.5114/wiitm.2022.124088.
Qin S. Guidelines on the diagnosis and treatment of primary liver cancer (2011 edition). Chin Clin Oncol 2012;1(1):10. https://doi.org/10.3978/j.issn.2304-38 65.2012.07.01.
Huang Q, Zou MH, Jiang Y, Chen ZP, Wang Q, Wei JC, Li WL, Cao J. Outcomes of laparoscopic surgery for mucinous colorectal adenocarcinoma. J Laparoendosc Adv Surg Tech A 2021;31(6):638-647. https:// doi.org/10.1089/lap.2020.0588.
Zhou J, Sun H-C, Wang Z, Cong W-M, Wang J-H, Zeng M-S, Yang J-M, Bie P, Liu L-X, Wen T-F, Han G-H, Wang M-Q, Liu R-B, Lu L-G, Ren Zh-G, Chen M-S, Zeng Z-Ch, Liang P, Liang Ch-H, Chen M, Yan F-H, Wang W-P, Ji Y, Cheng W-W, Dai C-L, Jia W-D, Li Y-M, Li Y-X, Liang J, Liu T-Sh, Lv G-Y, Mao Y-L, Ren W-X, Shi H-Ch, Wang W-T, Wang X-Y, Xing B-C, Xu J-M, Yang J-Y, Yang Y-F, Ye Sh-L, Yin Z-Y, Zhang B-H, Zhang Sh-J, Zhou W-P, Zhu J-Y, Liu R, Shi Y-H, Xiao Y-Sh, Dai Z, Teng G-J, Cai J-Q, Wang W-L, Dong J-H, Li Q, Shen F, Qin S-K, Fanl J. Guidelines for diagnosis and treatment of primary liver cancer in China (2017 Edition). Liver Cancer 2018;7(3):235-260. https://doi. org/10.1159/000488035.
Liu Y, Wang Q, Du B, Wang XZ, Xue Q, Gao WF. Meta-analysis of indocyanine green fluorescence imaging-guided laparoscopic hepatectomy. Photodiagnosis Photodyn Ther 2021;35:102354. https:// doi.org/10.1016/j.pdpdt.2021.102354.18.
Ibuki S, Hibi T, Tanabe M, Geller DA, Cherqui D, Wakabayashi G. Short-term outcomes of “difficult” laparoscopic liver resection at specialized centers: Report from INSTALL (International Survey on Technical Aspects of Laparoscopic Liver Resection)-2 on 4478 patients. Ann Surg 2022;275(5):940-946. https://doi. org/10.1097/SLA.0000000000004434.
Matsukuma S, Tokumitsu Y, Nakagami Y, Shindo Y, Matsui H, Nakajima M, Iida M, Suzuki N, Takeda Sh, Nagano H. Laparoscopic resection reduces superficial surgical site infection in liver surgery. Surg Endosc 2021;35(12):7131-7141. https:// doi.org/10.1007/s00464-020-08233-9.
Huang Y, Chen F, Li H. Effect of rapid rehabilitation nursing on inflammation and liver function after laparoscopic radical resection of primary liver cancer. Am J Transl Res 2022;14(11):8156-8165.
Fu XT, Tang Z, Chen JF, Shi YH, Liu WR, Gao Q, Ding G-Y, Song K, Wang X-Y, Zhou J, Fan J, Ding Z-B. Laparoscopic hepatectomy enhances recovery for small hepatocellular carcinoma with liver cirrhosis by postoperative inflammatory response attenuation: a propensity score matching analysis with a conventional open approach. Surg Endosc 2021;35(2):910-920. https://doi. org/10.1007/s00464-020-07710-5.
Schag CC, Heinrich RL, Ganz PA. Karnofsky performance status revisited: reliability, validity, and guidelines. J Clin Oncol 1984;2(3):187-193. https://doi. org/10.1200/JCO.1984.2.3.187.
Allaire M, Goumard C, Lim C, Le Cleach A, Wagner M, Scatton O. New frontiers in liver resection for hepatocellular carcinoma. JHEP Rep 2020;2(4):100134. https:// doi.org/10.1016/j.jhepr.2020.100134.
Sugawara Y, Hibi T. Surgical treatment of hepatocellular carcinoma. BioSci Trends 2021;15(3):138-41. https://doi. org/10.5582/bst.2021.01094.
Lubner MG, Mankowski Gettle L, Kim DH, Ziemlewicz TJ, Dahiya N, Pickhardt P. Diagnostic and procedural intraoperative ultrasound: technique, tips and tricks for optimizing results. Br J Radiol 2021;94(1121):20201406. https://doi.org/10.1259/bjr.20201406.
Joliat G-R, Kobayashi K, Hasegawa K, Thomson J-E, Padbury R, Scott M, Brustia R, Scatton O, Cao HST, Vauthey J-N, Dincler S, Clavien P-A, Wigmore SJ, Demartines N, Melloul E. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations 2022. World J Sur 2023;47(1):11-34. https://doi.org/10. 1259/bjr.20201406.
Tayar DO, Ribeiro U, Jr., Cecconello I, Magalhães TM, Simões CM, Auler JOC, Jr. Propensity score matching comparison of laparoscopic versus open surgery for rectal cancer in a middle-income country: short-term outcomes and cost analysis. Clinicoecon Outcomes Res 2018;10:521-527. https://doi.org/10.2147/CEOR.S173718.
Morise Z, Katsuno H, Kikuchi K, Endo T, Matsuo K, Asano Y, Horiguchi A. Laparoscopic repeat liver resection-selecting the best approach for repeat liver resection. Cancers 2023;15(2):421. https://doi. org/10.3390/cancers15020421.
Berardi G, Muttillo EM, Colasanti M, Mariano G, Meniconi RL, Ferretti S, Guglielmo N, Angrisani M, Lucarini A, Garofalo E, Chiappori D, Di Cesare L, Vallati D, Mercantini P, Ettorre GM. Challenging scenarios and debated indications for laparoscopic liver Resections for hepatocellular carcinoma. Cancers 2023;15(5):1493. https://doi.org/ 10.3390/cancers15051493.
Dąbrowska AM, Słotwiński R. The immune response to surgery and infection. Cent Eur J Immunol 2014;39(4):532-537. https://doi.org/10.5114/ceji.2014.47741.
Amodeo G, Bugada D, Franchi S, Moschetti G, Grimaldi S, Panerai A, Allegri M, Sacerdote P. Immune function after major surgical interventions: the effect of postoperative pain treatment. J Pain Res 2018;11:1297-1305. https://doi.org/ 10.2147/JPR.S158230.
Elshazly M, Khair T, Bassem M, Mansour M. The use of intraoperative bedside lung ultrasound in optimizing positive end expiratory pressure in obese patients undergoing laparoscopic bariatric surgeries. Surg Obes Relat Dis 2021;17(2):372-378. https://doi. org/10.1016/j.soard.2020.09.023.
Kurilova I, Bendet A, Petre EN, Boas FE, Kaye E, Gonen M, Covey A, Brody LA, Brown KT, Kemeny NE, Yarmohammadi H, Ziv E, D’Angelica MI, Kingham TP, Cercek A, Solomon SB, Beets-Tan RGH, Sofocleous CT. Factors associated with local tumor control and complications after thermal ablation of colorectal cancer liver metastases: a 15-year retrospective cohort study. Clinical Colorectal Cancer 2021;20(2):e82-e95. https://doi. org/10.1016/j.clcc.2020.09.005.
Skrzep-Poloczek B, Poloczek J, Chełmecka E, Kazura W, Dulska A, Idzik M, Jochem J, Stygar D. General, 21-day postoperative rehabilitation program has beneficial effect on oxidative stress markers in patients after total hip or knee replacement. Oxid Med Cell Longev 2020; 2020:4598437. https://doi. org/10.1155/2020/4598437.
Published
2024-05-21
How to Cite
Xu, Y., & Shen, L. (2024). Benefits of a modified local precision liver resection using intraoperative laparoscopic ultrasound in the treatment and prognosis of patients with liver cancer.: Beneficios de la resección hepática de precisión local modificada, utilizando ecografía intraoperatoria laparoscópica en el tratamiento y pronóstico de pacientes con cáncer de hígado. Investigación Clínica, 65(2), 155-168. https://doi.org/10.54817/IC.v65n2a03
Section
Original Works
