Aim: This retrospective study compares the outcome of patients undergoing anatomical versus non-anatomical hepatic resection for stage I and II HCC. Patients and methods: This retrospective study included 25 patients with T I and II HCC managed by hepatic resection. Patients were divided into two groups. Group A: Anatomic resection (n: 14) was treated by the complete removal of at least one liver segment. Group B: Non-anatomic resection (n:11) was treated by the resection of the tumor with a margin of at least 1 cm without regard to segmental, sectional or lobar anatomy. The two patients groups were subjected to a close follow-up of 23.9 ± 8.22 months. Results: No difference was detected between the 2 groups in clinical and demographic characteristics. Mean operative time was 3.11 ± 1.00 versus 3.18 ± 0.717 hours (p: 0.84). Mean operative blood loss was 1050± 626 versus 1045± 460 (p: 0.27). Mean tumor size was 4.00± 0.855 cm and 3.73 ± 1.06 cm (p: 0.48). Tumors were capsulated in 10 (71.4%) group A and 8 (72.7%) Group B patients. Resection margin was infiltrated in 2 (14.3%) and 1 (9.1 %) patients. Microscopic invasion was found in 5 (35.7%) and 4 (36.4%) patients. Mean period of hospital stay was 8.29 ± 7.04 and 6.45 ± 3.05 days (p: 0.43). There were early complications in 8 patients (57.1%) from group A and 3 patients (21.3%) from Group B (p: 0.15). Severe deterioration in liver functions and eventually death occurred in 1 patient and postoperative hemorrhagic shock and ARDS leading to death in 1 patient. During early follow up, 8 patients (57.1%) from group A and 8 patients (72.7%) from Group B developed recurrence; 3 patients (21.3%) and 4 patients (36.4%) within 1 year after operation. Mean time of recurrence was 14.0 ± 6.14 versus 12.1 ± 8.11 months (p: 0.61). Using the univariate analysis method, there was no difference between the 2 groups in recurrence (p: 0.44). Six patients (42.8%) from group A and 3 patients (27.3%) from group B died during the follow up period. Mean diseasefree survival was 15.071 ± 2.298 versus 15.182 ± 2.652 months (p: 0.98). Cumulative overall survival proportion was 58.2% versus 72.7%. Mean overall survival was 18.214 ± 2.361 months versus 21.909±1.156 (p: 0.21). Results of univariate analysis showed no statistically significant factors to differentiate between both groups. Conclusion: We conducted this retrospective analysis for patients with HCC undergoing hepatic resection, and examined the background and clinical outcomes. The local recurrence rate was similar after anatomical and non-anatomical resection. Disease-free and overall survivals after anatomical and non-anatomical resection were not significantly different. Hepatic resection in cirrhotic patients should be done with good expertise and follows strict selection criteria. Non-Anatomical resection may be more preferable in cirrhotic patients with small HCC to leave adequate functioning liver parenchyma and to avoid increased postoperative morbidity
H, A., I, H., T, I., M, E., M, A., M, S., & O, H. (2015). Anatomic Versus Non-Anatomic Hepatic Resection for Patients with Stage I and II Hepatocellular Carcinoma. Ain Shams Journal of Surgery, 8(2), 151-161. doi: 10.21608/asjs.2015.195104
MLA
Abdelhady H; Hosssam I; Ismaeil T; El-sheikh M; Abdelwahab M; Soliman M; Hassan O. "Anatomic Versus Non-Anatomic Hepatic Resection for Patients with Stage I and II Hepatocellular Carcinoma". Ain Shams Journal of Surgery, 8, 2, 2015, 151-161. doi: 10.21608/asjs.2015.195104
HARVARD
H, A., I, H., T, I., M, E., M, A., M, S., O, H. (2015). 'Anatomic Versus Non-Anatomic Hepatic Resection for Patients with Stage I and II Hepatocellular Carcinoma', Ain Shams Journal of Surgery, 8(2), pp. 151-161. doi: 10.21608/asjs.2015.195104
VANCOUVER
H, A., I, H., T, I., M, E., M, A., M, S., O, H. Anatomic Versus Non-Anatomic Hepatic Resection for Patients with Stage I and II Hepatocellular Carcinoma. Ain Shams Journal of Surgery, 2015; 8(2): 151-161. doi: 10.21608/asjs.2015.195104