Therapeutic effect of anterior approach combined with liver hanging maneuver for right hepatectomy in patients with large hepatocellular carcinoma / 中华普通外科杂志

ABSTRACT

Objective@#To evaluate hepatectomy by anterior approach combined with liver hanging maneuver against conventional right hepatectomy in patients with large hepatocellular carcinoma (HCC).@*Methods@#Of the 62 cases, 29 patients underwent anterior approach hepatectomy and 33 did conventional hepatectomy.@*Results@#The overall operative time (t=1.815, P=0.037) and parenchymal transsection time (t=4.591, P=0.000) were longer in the anterior approach group than in the conventional group. More cases got radical resection in the anterior group (χ2=7.280, P=0.007). Log-rank test showed that 1, 3 and 5-year overall survival rate (OS) in the anterior approach group and the conventional group was 86.1%, 50.1%, 32.6% vs 75.8%, 30.3%, 18.9%, respectively (χ2=5.24, P=0.022), 1, 3 and 5-year disease free survival rate (DFS) were 75.3%, 42.1%, 31.0% vs 66.1%, 24.4%, 10.1%, respectively (χ2=4.38, P=0.037), and recurrence rate were 23.6%, 49.5%, 64.8% vs 36.7%, 63.7%, 82.5%, respectively (χ2=5.61, P=0.018).@*Conclusion@#Long term survival of patients with large sized HCC undergoing hepatectomy through the anterior approach combined with liver hanging maneuver is better than that of conventional approach.