Impact of Three-Dimensional Reconstruction Technique in the Operation Planning of Centrally Located Hepatocellular Carcinoma

BACKGROUND: The aim of this retrospective study was to compare the outcomes of operations based on 3-dimensional (3D) operation planning with non 3D-assisted operations in the treatment of centrally located hepatocellular carcinoma. STUDY DESIGN: From April 2008 to March 2014, 116 patients with centrally located hepatocellular carcinoma received surgical treatment in our department. Among these cases, a total of 60 patients received resection with operation planning based on 3D reconstructions (group A); the remaining 56 received treatment with the aid of traditional imaging (group B). Three-dimensional surgical planning, including the classification system for centrally located hepatocellular carcinoma, was elaborated in the study. RESULTS: Compared with group B, group A was linked to shorter operation time (294.5 +/- 61.9 minutes vs 324.3 +/- 83.1 minutes; p = 0.028) and lower rate of hepatic inflow occlusion (51.7% vs 71.4%; p = 0.029). No differences were found in surgical methods, intraoperative blood transfusion, and intraoperative blood loss. The groups were similar in their rates of complications, except that group B was more liable to have Clavien Grade III to V complications (3.3% vs 14.3%; p = 0.048). In addition, a significant difference in ascites was found across the 2 cohorts (2 in group A and 8 in group B; p = 0.048), and the 2 groups also differed significantly in total bilirubin (23.2 = 16.1 g/L vs 31.1 +/- 24.1 g/L; p = 0.032) and albumin (29.3 +/- 5.2 g/L vs 27.8 +/- 7.9 g/L; p = 0.033). CONCLUSIONS: Compared with non 3D-assisted operations, the operation planning based on 3D reconstruction is a more effective and reasonable method in the treatment of centrally located hepatocellular carcinoma. In addition, the classification system may facilitate the 3D operation planning. ((C) 2015 by the American College of Surgeons)