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ISSN: 2392-1099
Clinical and Experimental Hepatology
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2/2022
vol. 8
 
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abstract:
Original paper

Survival outcomes of the combination of extrafascial extrahepatic and extrafascial intrahepatic pedicle approaches in hepatectomy for hepatocellular carcinoma

Toan Huy Nguyen
1
,
Quyet Van Ha
2
,
Huong Van Nguyen
1
,
Duyet Van Pham
3
,
Thuong Van Pham
3
,
Thanh Van Le
4
,
Xuan Anh Le
1
,
Ai Quoc Dang
2

  1. Department of General Surgery, Nghe An General Hospital, Vietnam
  2. Department of General Surgery, Ha Noi Medical University, Vietnam
  3. Surgery Department, Hai Phong University of Medicine and Pharmacy, Vietnam
  4. Hepatobiliary and Pancreatic Surgery, 108 Military Central Hospital, Vietnam
Clin Exp HEPATOL 2022; 8, 2: 147-152
DOI: https://doi.org/10.5114/ceh.2022.116156
Online publish date: 2022/05/26
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Introduction
This study was conducted to evaluate the results of hepatectomy for hepatocellular carcinoma (HCC) by the combination of extrafascial extrahepatic (Takasaki method) and extrafascial intrahepatic pedicle approaches (Ton That Tung method).

Material and methods
A longitudinal follow-up study was conducted on 83 patients undergoing hepatectomy for HCC using the combination of extrafascial extrahepatic (Takasaki method) and extrafascial intrahepatic pedicle approaches at Nghe An Provincial Hospital from April 2017 to July 2021. Survival analysis was applied.

Results
The cumulative overall survival (OS) rates after 1, 2, 3 and 4 years were 88.4%, 76.3%, 69.5% and 56.9%, respectively. The mean OS time was 40.68 ±2.17 months. The 1-, 2-, 3- and 4-year disease-free survival (DFS) rates were 67.1%, 56%, 53.1% and 50%, respectively. The mean DFS time was 32.58 ±2.56 months. Surgical margin > 1 cm was an independent predictor of both overall and disease-free survival (HR = 5.194, 95% CI = 1.467-18,385, p = 0.011 for OS; HR = 2.822, 95% CI = 1.231-6.468, p = 0.014 for DFS).

Conclusions
Hepatectomy for HCC by a combination of extrafascial extrahepatic (Takasaki method) and extrafascial intrahepatic pedicle approaches (Ton That Tung method) is effective and safe, and side effects and complications can be controlled. Patient selection is a key issue and plays a very important role in the outcome of treatment. Key words: anatomical liver resection, hepatectomy, Takasaki’s technique.

keywords:

anatomical liver resection, hepatectomy, Takasaki’s technique
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