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THE REGIONAL LYMPHADENECTOMY IN ANATOMICAL RIGHT HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA
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Abstract
Objective: To describe the patient characteristics underwent anatomical right hepatectomy with local lymph node resection for hepatocellular carcinoma (HCC) and evaluate the impact of local lymphadenectomy to postoperative outcomes. Subjects and methods: This was a retrospective descriptive study of the cases who underwent anatomical right hepatetomy for hepatocellular carcinoma at the Department of Hepatobiliary and Pancreatic Surgery, K Hospital, from January 2022 to July 2023. Results: Anatomical right hepatectomy was performed for 110 patients, in which 31 patients underwent local lymphadenectomy, including lymph nodes at hepatoduodenal ligament, along common hepatic artery and retro-pancreatic space. The average age was 50,5 ± 14,6 years; 93,5% of patients were male; hepatitis B related: 38,7%. The mean AFP was 2560,1 ± 6074,9 ng/ml. Right portal vein thrombosis was seen in 2 patients (6,5%). The mean tumor size in the CT scan was 8,3 ± 3,9 cm. Takasaki’s method was the majority of extrahepatic Glissonean pedicle isolation (80,6%). The mean operation time was 164,5 ± 41,7 min. There was no intraoperative blood transfusion. Postoperative complications occurred in 14 patients, including ascites (45,2%) and pleural effusion (3,2%). The classification of complications according to Clavien–Dindo indicated: grade I (78,6%), grade II (14,3%), and grade IIIa (7,1%). There was no perioperative mortality. The average length of hospital stay was 14,9 ± 9,9 days. Total resected lymph nodes were 128, in which metastesis was found in one lymph node (0,78%). Lymph node dissection significantly prolonged operative duration (p=0,04) and resulted in a notable increase in postoperative ascites formation (p=0,002). However, the incidence of severe postoperative complications (p=0,3) and length of hospital stay (p=0,06) remained statistically unchanged. Conclusion: Anatomical right hepatectomy with local lymph node resection for hepatocellular carcinoma is feasible, safe, and effective
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Keywords
anatomical right hepatectomy, local lymph nodes resection, hepatocellular carcinoma.
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