Laparoscopic liver resection is associated with less significant muscle loss than the conventional open approach

World Journal of Surgical Oncology

Research

Hsin-Yi Chen¹  Ming-Chin Yu²  Haw-En Wang³  Sheng-Fu Wang³  Chien-Chih Chiu⁴  Ruoh-Yun Gau⁵  Kun-Ming Chan⁶  Wei-Chen Lee⁶  Chao-Wei Lee⁷  Hsin-I Tsai⁸  Mei-Ling Cheng⁹ 

[1] College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan;Department of Nursing, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Department of Cancer Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Division of General Surgery, Department of Surgery, New Taipei Municipal Tu-Cheng Hospital (built and operated by Chang Gung Medical Foundation), Tu-Cheng, New Taipei City, Taiwan;Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Department of Nursing, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Division of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, 33305, Taoyuan, Taiwan;Division of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, 33305, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan;Division of General Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Guishan, 33305, Taoyuan, Taiwan;Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan;Graduate Institute of Clinical Medical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan;College of Medicine, Chang Gung University, Guishan, Taoyuan, Taiwan;Department of Anesthesiology, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;Metabolomics Core Laboratory, Healthy Aging Research Center, Chang Gung University, Guishan, Taoyuan, Taiwan;Department of Biomedical Sciences, Chang Gung University, Guishan, Taoyuan, Taiwan;Clinical Metabolomics Core Laboratory, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan;

关键词: Laparoscopic;    Liver resection;    Hepatectomy;    Hepatocellular carcinoma;    Sarcopenia;    Muscle loss;   

DOI  :  10.1186/s12957-022-02854-1

 received in 2022-08-27, accepted in 2022-11-24,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundLaparoscopic liver resections (LLR) have been shown a treatment approach comparable to open liver resections (OLR) in hepatocellular carcinoma (HCC). However, the influence of procedural type on body composition has not been investigated. The aim of the current study was to compare the degree of skeletal muscle loss between LLR and OLR for HCC.MethodsBy using propensity score matching (PSM) analysis, 64 pairs of patients were enrolled. The change of psoas muscle index (PMI) after the operation was compared between the matched patients in the LLR and OLR. Risk factors for significant muscle loss (defined as change in PMI > mean change minus one standard deviation) were further investigated by multivariate analysis.ResultsAmong patients enrolled, there was no significant difference in baseline characteristics between the two groups. The PMI was significantly decreased in the OLR group (P = 0.003). There were also more patients in the OLR group who developed significant muscle loss after the operations (P = 0.008). Multivariate analysis revealed OLR (P = 0.023), type 2 diabetes mellitus, indocyanine green retention rate at 15 min (ICG-15) > 10%, and cancer stage ≧ 3 were independent risk factors for significant muscle loss. In addition, significant muscle loss was associated with early HCC recurrence (P = 0.006). Metabolomic analysis demonstrated that the urea cycle may be decreased in patients with significant muscle loss.ConclusionLLR for HCC was associated with less significant muscle loss than OLR. Since significant muscle loss was a predictive factor for early tumor recurrence and associated with impaired liver metabolism, LLR may subsequently result in a more favorable outcome.

【 授权许可】

CC BY   
© The Author(s) 2022

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