A Prospective Cohort Study: Laparoscopic Versus Open Surgery for Lesions Originating in the Paracaval Portion of the Caudate Lobe
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Paracaval Portion
- Sponsor
- Southwest Hospital, China
- Enrollment
- 110
- Locations
- 1
- Primary Endpoint
- survival rate
- Last Updated
- 5 years ago
Overview
Brief Summary
This study aimed to evaluate the safety, feasibility and efficacy of laparoscopic for resecting paracaval-originating lesions by contrast of open procedures.
Detailed Description
The paracaval portion of the caudate lobe is located in the core of the liver. Lesions originating in the paracaval portion often cling to or even invade major hepatic vascular structures. Open surgery is the traditional surgical method for resection of paracaval-originating lesions. With the development of laparoscopic surgery, paracaval-originating lesions are no longer an absolute contraindication for laparoscopic procedures. The high-definition magnified view and ability to change perspectives with the laparoscope are conducive to subtle manipulation, and compression of the carbon dioxide pneumoperitoneum can reduce venous bleeding. Nevertheless, laparoscopic anterior hepatic transection for paracaval-originating lesion resection is still a challenging procedure, and only a few cases have been reported. This study aimed to evaluate the safety, feasibility and efficacy of laparoscopic for resecting paracaval-originating lesions by contrast of open procedures.
Investigators
Shuguo Zheng, MD
Professor of Hepatobiliary Surgery Institute; Chief Physician; Administrator of laparoscopic department
Southwest Hospital, China
Eligibility Criteria
Inclusion Criteria
- •Age: Between 18 to 70 years, both male and female
- •The general condition of the patient can tolerate anesthesia and surgery
- •Paracaval-originating lesion diagnosis is clear preoperative
- •No rupture of the tumor, no bloody ascites, no invasion of the surrounding tissues and distant metastasis
- •Liver function ≥ Child-pugh level B, indocyanine green retention rate at 15 min ≤ 15%, the residual liver volume and standard liver volume ratio ≥ 40%.
- •Upper abdominal surgery, radiofrequency ablation, Transhepatic Arterial Chemotherapy And Embolization treatment, radiotherapy and chemotherapy have not been implemented
- •Volunteer to participate in the study and sign informed consent
Exclusion Criteria
- •Age:Younger than 18 or more than 70 years old
- •Pregnant and lactating women
- •Severe cirrhosis, portal hypertension, or active hepatitis are present
- •Severe upper abdominal adhesions
- •The lesion originated in other parts of the liver other than the paracaval portion
- •Patients with poor general condition and could not tolerate surgery or anesthesia
Outcomes
Primary Outcomes
survival rate
Time Frame: 3 years
follow-up after the surgery every 3months, to understand relapse, death, statistics 1-year, 3-year overall survival rates，disease-free survival rates , recurrence and metastasis rate.
Secondary Outcomes
- operation time(during the operation)
- intraoperative blood loss(during the operation)
- rate of blood transfusion.(during the operation)