Laparoscopic versus Traditional Open Splenectomy for Hepatocellular Carcinoma with Hypersplenism

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 36; no. 4; pp. 519 - 522
• Main Author: 董汉华 梅斌 刘飞龙 张志伟 张必翔 黄志勇 陈孝平 张万广
• Format: Journal Article
• Language: English
• Published: Wuhan Huazhong University of Science and Technology 01.08.2016; Hepatic Surgery Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030,China
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Female; Hepatectomy; Humans; Hypersplenism - complications; Hypersplenism - pathology; Hypersplenism - surgery; Laparoscopy; Liver - pathology; Liver - surgery; Liver Neoplasms - complications; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Spleen - pathology; Spleen - surgery; Splenectomy; Treatment Outcome; 传统; 合并; 并发症; 死亡率; 肝癌; 肝细胞癌; 脾; 腹腔镜; laparoscopic hepatectomy; laparoscopic splenectomy; hypersplenism
• ISSN: 1672-0733; 1993-1352; 1993-1352
• DOI: 10.1007/s11596-016-1618-3

This study aimed to examine the efficacy of the laparoscopic vs. traditional open splenectomy for hepatocellular carcinoma（HCC） with hypersplenism. Between 2002 and 2013, 51 Chinese HCC patients with hypersplenism underwent either simultaneous laparoscopic splenectomy plus anticancer therapies（Lap-S＆A）（n=25） or traditional open splenectomy plus anti-cancer therapies（TOS＆A）（n=26）. The outcomes were reviewed during and after the operation. Anti-cancer therapies for HCC included laparoscopic hepatectomy（LH） and laparoscopic microwave ablation（LMA）. The results showed that there was no significant difference in the operating time between the two groups, but the blood loss and blood transfusion were less, pain intensity after surgery was weaker, the time to first bowel movement, time to the first flatus and postoperative hospital stay were shorter, and the postoperative complication rate and the readmission rate were lower in the Lap-S＆A group than in the TO-S＆A group. Two patients in the Lap-S＆A group and one patient in the TO-S＆A group died 30 days after surgery. However, no significant difference in the mortality rate was noted between the two groups. It was concluded that simultaneous Lap-S＆A holds the advantages of more extensive indications, lower complication incidence and less operative expenditure than conventional open approach and it is a feasible and safe approach for HCC with hypersplenism.