Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 009] The Relationship between Operative Approach And Pulmonary Complications after Hepatectomy for HCC: a Multicenter Overlap Propensity Score-Weighted Analysis of Laparoscopic Vs. Open Hepatectomy
Jia-Hao XU 1, Xue-Dong WANG 3, Xiao-Chang WU 4, Ming-Da WANG 1, Zhong-Qi FAN 2, Qi-Xuan ZHENG 5, Ya-Hao ZHOU 6, Hong WANG 7, Guo-Yue LV 2, Tian YANG 1
1 Hepatobiliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University (Navy Medical University), CHINA, 2 Hepatobiliary And Pancreatic Surgery, General Surgery Center, First Hospital of Jilin University, CHINA, 3 Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, CHINA, 4 Hepatobiliary Surgery, Huzhou Central Hospital, Zhejiang University Huzhou Hospital, CHINA, 5 Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong University, CHINA, 6 Hepatobiliary Surgery, Pu’er People’s Hospital, CHINA, 7 General Surgery, Liuyang People’s Hospital, CHINA
Background : Postoperative pulmonary complications (PPCs) significantly affect patient recovery and long-term outcomes in hepatocellular carcinoma (HCC) post-hepatectomy. This study examines the potential benefits of laparoscopic hepatectomy (LH) over traditional open hepatectomy (OH) in reducing PPCs.
Methods : A multicenter retrospective cohort study across 12 Chinese centers (2010-2021) involved 4,694 HCC patients undergoing LH or OH. Primary endpoint: PPCs incidence, including pleural effusion, respiratory insufficiency, acute respiratory distress syndrome, pulmonary infection, and pulmonary embolism. Propensity score analysis, inverse probability of treatment weighting (IPTW), multivariable logistic regression, and subgroup analyses adjusted for confounders.
Results : Of 4,694 patients, 766 (16.3%) had LH, and 3,928 (83.7%) had OH. Overall PPCs incidence was 10.9%, significantly lower in LH (7.3%) than OH (11.6%, P = 0.001). IPTW analysis supported these results (7.4% vs. 11.6%, P = 0.011). Multivariable analysis revealed LH independently associated with lower PPCs risk (adjusted odds ratio 0.63, 95% CI: 0.42-0.92, P = 0.018). Subgroup analyses across demographics and clinical parameters consistently validated this association.
Conclusions : Laparoscopic hepatectomy in HCC patients is linked to a significantly lower incidence of PPCs compared to the open approach. These findings suggest LH as a more favorable surgical option for HCC, emphasizing its potential benefits in improving postoperative pulmonary outcomes. The study contributes to the growing evidence favoring minimally invasive surgery in oncological procedures and underscores the need for wider adoption in clinical practice.
Methods : A multicenter retrospective cohort study across 12 Chinese centers (2010-2021) involved 4,694 HCC patients undergoing LH or OH. Primary endpoint: PPCs incidence, including pleural effusion, respiratory insufficiency, acute respiratory distress syndrome, pulmonary infection, and pulmonary embolism. Propensity score analysis, inverse probability of treatment weighting (IPTW), multivariable logistic regression, and subgroup analyses adjusted for confounders.
Results : Of 4,694 patients, 766 (16.3%) had LH, and 3,928 (83.7%) had OH. Overall PPCs incidence was 10.9%, significantly lower in LH (7.3%) than OH (11.6%, P = 0.001). IPTW analysis supported these results (7.4% vs. 11.6%, P = 0.011). Multivariable analysis revealed LH independently associated with lower PPCs risk (adjusted odds ratio 0.63, 95% CI: 0.42-0.92, P = 0.018). Subgroup analyses across demographics and clinical parameters consistently validated this association.
Conclusions : Laparoscopic hepatectomy in HCC patients is linked to a significantly lower incidence of PPCs compared to the open approach. These findings suggest LH as a more favorable surgical option for HCC, emphasizing its potential benefits in improving postoperative pulmonary outcomes. The study contributes to the growing evidence favoring minimally invasive surgery in oncological procedures and underscores the need for wider adoption in clinical practice.
SESSION
E-poster
E-Session 03/21 ALL DAY