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| 1 | Hepatic resection beyond barcelona clinic liver cancer indication:When and how显示文摘Hepatocellular carcinoma(HCC)is the main common primary tumour of the liver and it is usually associated with cirrhosis.The barcelona clinic liver cancer(BCLC)classification has been approved as guidance for HCC treatment algorithms by the European Association for the Study of Liver and the American Association for the Study of Liver Disease.According to this algorithm,hepatic resection should be performed only in patients with small single tumours of 2-3 cm without signs of portal hypertension(PHT)or hyperbilirubinemia.BCLC classification has been criticised and many studies have shown that multiple tumors and large tumors,as wide as those with macrovascular infiltration and PHT,could benefit from liver resection.Consequently,treatment guidelines should be revised and patients with intermediate/advanced stage HCC,when technically resectable,should receive the opportunity to be treated with radical surgical treatment.Nevertheless,the surgical treatment of HCC on cirrhosis is complex:The goal to be oncologically radical has always to be balanced with the necessity to minimize organ damage.The aim of this review was to analyze when and how liver resection could be indicated beyond BCLC indication.In particular,the role of multidisciplinary approach to assure a proper indication,of the intraoperative ultrasound for intraoperative restaging and resection guidance and of laparoscopy to minimize surgical trauma have been enhanced. | Mattia Garancini Enrico Pinotti Stefano Nespoli Fabrizio Romano Luca Gianotti Vittorio Giardini | 2016 | World Journal of Hepatology2016，8，11： | 8 |
| 2 | Comparative study and systematic review of laparoscopic liver resection for hepatocellular carcinoma显示文摘AIM: To compare the surgical outcomes between laparoscopic liver resection(LLR) and open liver resection(OLR) as a curative treatment in patients with hepatocellular carcinoma(HCC). METHODS: A Pub Med database search was performed systematically to identify comparative studies of LLR vs OLR for HCC from 2000 to 2014. An extensive text word search was conducted, using combinations of search headings such as 'laparoscopy', 'hepatectomy', and 'hepatocellular carcinoma'. A comparative study was also performed in our institution where we analysed surgical outcomes of 152 patients who underwent liver resection between January 2005 to December 2012, of which 42 underwent laparoscopic or hand-assisted laparoscopic resection and 110 underwent open resection. RESULTS: Analysis of our own series and a review of 17 high-quality studies showed that LLR was superior to OLR in terms of short-term outcomes, as patients in the laparoscopic arm were found to have less intraoperative blood loss, less blood transfusions, and a shorter length of hospital stay. In our own series, both LLR and OLR groups were found to have similar overall survival(OS) rates, but disease-free survival(DFS) rates were higher in the laparoscopic arm. CONCLUSION: LLR is associated with better short-term outcomes compared to OLR as a curative treatment for HCC. Long-term oncologic outcomes with regards to OS and DFS rates were found to be comparable in both groups. LLR is hence a safe and viable option for curative resection of HCC. | Wei Qi Leong Iyer Shridhar Ganpathi Alfred Wei Chieh Kow Krishnakumar Madhavan Stephen Kin Yong Chang | 2015 | World Journal of Hepatology2015，7，27： | 7 |
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