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Minimally invasive surgery for hilar cholangiocarcinoma: a multicenter retrospective analysis of 158 patients

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单位: [1]North Sichuan Med Coll, Affiliated Hosp, Dept Gen Surg, Inst Hepatobiliary Pancreat Intestinal Dis, 63 Wenhua Rd, Shunqing Dist 637000, Nanchong, Peoples R China [2]Hebei Med Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, Shijiazhuang 200092, Hebei, Peoples R China [3]Xuzhou Med Univ, Affiliated Hosp, Dept Hepatobiliary Surg, Xuzhou 221006, Jiangsu, Peoples R China [4]Huazhong Univ Sci & Technol,Tongji Med Coll,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,Wuhan 430030,Peoples R China [5]Hunan Prov Peoples Hosp, Dept Hepatobiliary Surg, Changsha 410005, Peoples R China [6]Army Med Univ, Hosp 1, Dept Biliary Surg, Chongqing 400038, Peoples R China [7]Zhejiang Univ, SirRunRunShaw Hosp, Dept Hepatobiliary Surg, Hangzhou 310020, Peoples R China [8]Sichuan Univ, West China Hosp, Dept Biliary Surg, Chengdu 610041, Peoples R China [9]Southern Med Univ, Nanfang Hosp, Dept Hepatobiliary Surg, Guangzhou 510515, Peoples R China [10]Chongqing Med Univ, Affiliated Hosp 1, Dept Hepatobiliary Surg, Chongqing 400016, Peoples R China [11]Shanghai Jiao Tong Univ, Sch Med, Xinhua Hosp, Dept Gen Surg, 1665 Kong Jiang Rd, Shanghai 200000, Peoples R China
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关键词: Hilar cholangiocarcinoma Minimally invasive surgery Multicenter clinical study

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Background Curative resection of hilar cholangiocarcinoma (HC) is typically carried out using open surgery. In the present study, we examined the safety (postoperative complication) and effectiveness (resection margin status and patient survival) of minimally invasive surgery (MIS) for HC. Methods This retrospective analysis included 158 patients receiving MIS for HC at 10 participating centers between December 2013 and November 2019. Patient demographics, surgical outcomes, and oncological outcomes were retrospectively analyzed. Results Clinical information obtained from 10 different clinical centers did not show any evident cohort-bias clustering. One hundred and twenty-six (79.7%) patients underwent LRHC, 12 (7.6%) patients underwent RARHC, conversion to an open procedure occurred in 20 (12.7%) patients. The operation time and estimated blood loss were 410.8 +/- 128.9 min and 477.8 +/- 706.3 mL, respectively. The surgical radicality of the 158 patients was R0, 129 (81.6%); R1, 20 (18.4%) and R2, 9 (5.7%). Grades I-II complications was occurred in 68 (43.0%) patients. Severe morbidity (grade III-V) occurred in 14 (8.7%) patients. The median overall survival in whole cohort was 25.4 months. The overall survival rate was 67.6% at year 1, 28.8% at year 3, and 19.2% at year 5. Comparing the first half of MISHC performed by each center with the following cases, the operation time and postoperative hospital stay does not decrease with the increasing cases. On literature review, MISHC is non-inferior to open surgery at least in perioperative period. Conclusions In this Chinese MIS for HC multicenter study, the largest to date, long-term overall survival rates after MIS appear comparable to those reported in current open series. Further randomized controlled trials are necessary to assess the global impact of MISHC.

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出版当年[2020]版:
大类 | 3 区 医学
小类 | 2 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者单位: [1]North Sichuan Med Coll, Affiliated Hosp, Dept Gen Surg, Inst Hepatobiliary Pancreat Intestinal Dis, 63 Wenhua Rd, Shunqing Dist 637000, Nanchong, Peoples R China
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