Advances in Liver Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 1966

Special Issue Editor


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Guest Editor
Department of Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
Interests: liver transplantation; liver surgery; hepatocellular carcinoma; minimal invasive surgery
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Special Issue Information

Dear Colleagues,

Liver cancers including hepatocellular carcinoma (HCC) are one of leading causes of cancer-related deaths worldwide. Liver transplantation is generally considered the most curative treatment, but it is limited by the imbalance between the numbers of recipients and available donors. Recently, laparoscopic liver resection has been developed and widely accepted for standard care of treatment for liver tumor.

We are pleased to invite you to contribute to this Special Issue titled “Advances in Liver Surgery”. This Special Issue aims to showcase standards for the treatment of liver cancer and investigate evidence, technical improvement, and expert’s perspectives on the treatment of liver cancer.

In this Special Issue, original research articles and reviews are welcome.

I look forward to receiving your contributions.

Prof. Dr. Jai Young Cho
Guest Editor

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Keywords

  • hepatocellular carcinoma
  • liver cancer
  • laparoscopic hepatectomy
  • minimally invasive liver resection
  • liver transplantation
  • technique

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Published Papers (2 papers)

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Research

14 pages, 761 KiB  
Article
Impact of Paired Remote Ischemic Preconditioning on Postreperfusion Syndrome in Living-Donor Liver Transplantation: A Propensity-Score Matching Analysis
by Jaewon Huh and Min Suk Chae
Medicina 2024, 60(11), 1830; https://doi.org/10.3390/medicina60111830 - 7 Nov 2024
Viewed by 682
Abstract
Background and Objectives: Postreperfusion syndrome (PRS) is a significant challenge in liver transplantation (LT), leading to severe circulatory and metabolic complications. Ischemic preconditioning (IPC), including remote IPC (RIPC), can mitigate ischemia-reperfusion injury, although its efficacy in LT remains unclear. This study evaluated [...] Read more.
Background and Objectives: Postreperfusion syndrome (PRS) is a significant challenge in liver transplantation (LT), leading to severe circulatory and metabolic complications. Ischemic preconditioning (IPC), including remote IPC (RIPC), can mitigate ischemia-reperfusion injury, although its efficacy in LT remains unclear. This study evaluated the impact of paired RIPC, involving the application of RIPC to both the recipient and the living donor, on the incidence of PRS and the need for rescue epinephrine during living-donor LT (LDLT). Materials and Methods: This retrospective observational cohort analysis included 676 adult patients who had undergone elective LDLT between September 2012 and September 2022. After applying exclusion criteria and propensity score matching (PSM), 664 patients were categorized into the paired RIPC and non-RIPC groups. The primary outcomes were the occurrence of PRS and the need for rescue epinephrine during reperfusion. Results: The incidence of PRS and the need for rescue epinephrine were significantly lower in the paired RIPC group than in the non-RIPC group. Furthermore, the incidence of postoperative acute kidney injury was lower in the paired RIPC group. Multivariable logistic regression adjusted for propensity scores indicated that paired RIPC was significantly associated with a reduced occurrence of PRS (odds ratio: 0.672, 95% confidence interval: 0.479–0.953, p = 0.021). Conclusions: Paired RIPC, involving both the recipient and the living donor, effectively reduces the occurrence of PRS and the need for rescue epinephrine during LDLT. These findings suggest that paired RIPC protects against ischemia-reperfusion injury in LDLT. Future randomized controlled trials are needed to verify our results and to explore the underlying mechanisms of the protective effects of RIPC. Full article
(This article belongs to the Special Issue Advances in Liver Surgery)
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12 pages, 679 KiB  
Article
A Decade of Experience Between Open and Minimally Invasive Hepatectomies for Hepatocellular Carcinoma
by Andrew Min-Gi Park, Ye In Christopher Kwon, Kush Savsani, Aadi Sharma, Yuzuru Sambommatsu, Daisuke Imai, Aamir Khan, Amit Sharma, Irfan Saeed, Vinay Kumaran, Adrian Cotterell, Marlon Levy, David Bruno and Seung Duk Lee
Medicina 2024, 60(11), 1737; https://doi.org/10.3390/medicina60111737 - 23 Oct 2024
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Abstract
Background and Objectives: Hepatic resection offers promising outcomes for patients with hepatocellular carcinoma (HCC) but can be constrained by factors like patient suitability. Continuous advancements in laparoscopic and robotic technologies have made minimally invasive hepatectomies (MIHs) a viable alternative to open hepatectomies [...] Read more.
Background and Objectives: Hepatic resection offers promising outcomes for patients with hepatocellular carcinoma (HCC) but can be constrained by factors like patient suitability. Continuous advancements in laparoscopic and robotic technologies have made minimally invasive hepatectomies (MIHs) a viable alternative to open hepatectomies with benefits in terms of recovery and complications. Materials and Methods: We completed a retrospective review on 138 HCC patients who underwent OH or MIH between 2010 and 2020 at the Hume-Lee Transplant Center. Univariate and multivariate analyses were completed on demographic, clinical, and tumor-specific data to assess the impact of these variables on overall and disease-free survival at 1, 3, and 5 years. Preoperative metrics like length of hospital stay (LOS) and operation duration were also evaluated. Results: Of the 109 OH and 29 MIH patients, MIH patients demonstrated shorter LOS and operative times. However, overall survival (OS) and disease-free survival (DFS) were similar between groups, with no significant variations in 1-, 3-, and 5-year survival rates. Age > 60 years and a lack of preoperative transcatheter arterial chemoembolization (TACE) were significant predictors of inferior OS and DFS in multivariate analyses. Conclusions: MIH is an efficient substitute for OH with comparable survival, even in older patients. The reduced LOS and operation time enhance its feasibility, and older patients previously denied for curative resection may qualify for MIH. Preoperative TACE also enhances survival outcomes, emphasizing its general role in managing resectable HCCs. Both robotic and laparoscopic hepatectomies offer acceptable short- and long-term clinical outcomes, highlighting MIH as the standard choice for HCC patients. Full article
(This article belongs to the Special Issue Advances in Liver Surgery)
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