Evidence map›Paper›PMID 39681679›Full record

ArticleSurgical endoscopy2025

Feasibility and safety of minimally invasive R1 vascular surgery for hepatocellular carcinoma: a cohort study.

Schaima Abdelhadi, Flavius Sandra-Petrescu, Georgi Vassilev, Emrullah Birgin, Nuh N Rahbari, Christoph Reissfelder

Abstract read
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Schaima AbdelhadiDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany. schaima.abdelhadi@umm.de.ORCID 0009-0001-7332-9240
Flavius Sandra-PetrescuDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Georgi VassilevDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Emrullah BirginDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Nuh N RahbariDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Christoph ReissfelderDepartment of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn recent studies addressing colorectal liver metastases and HCC, R1 vascular surgery has demonstrated safety and oncological adequacy. Recognizing that patient prognosis after liver surgery for HCC depends more on preserving an adequate future liver remnant than on the width of the surgical margin, this surgical approach has achieved rising interest. However, data for its feasibility and safety for minimally invasive approaches for HCC resections are limited. Therefore, the aim of our study was to determine the feasibility and safety of minimally invasive R1 vascular surgery for HCC.

methodsConsecutive patients who underwent curative hepatectomies between April 2018 and May 2023 were identified from a prospectively collected institutional database. Intraoperative ultrasound was performed to guide the resection, confirm the preoperative finding regarding the tumor's relation to the main vessels, and exclude any undetected vascular invasion or additional lesions. Postoperative complications were graded according to the Clavien-Dindo classification.

resultsAmong 58 patients included, 22 (38%) underwent minimally invasive R1vasc surgery for HCC and 36 (62%) non-R1vasc surgery. In the MI-R1vasc surgery group, there were significantly more infiltrated liver segments (2 vs. 1, p = 0.04) and a shorter tumor distance to the main hepatic veins (5 mm vs. 21 mm, p < 0.001) and Glissonean pedicles (4 mm vs. 26 mm, p < 0.001) than in MI-non-R1vasc surgery group. The comparisons of the type of surgical resection revealed similar findings between the study groups, with non-anatomic resections and segmentectomies being the most frequently performed resections. The median blood loss (600 ml vs. 500 ml, p = 0.41), operative time (264 min vs. 231 min, p = 0.13), and R1par resection rate (5% vs. 3%, p = 0.72) were comparable in both groups. Other intra- and postoperative outcomes were also comparable between the two groups.

conclusionMinimally invasive R1 vascular surgery is safe and feasible for patients with Hepatocellular Carcinoma.

Indexed as

Carcinoma, HepatocellularHepatectomyLiver NeoplasmsMinimally Invasive Surgical ProceduresVascular Surgical ProceduresAgedFeasibility StudiesFemaleHepatic VeinsHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesHepatectomyHepatocellular carcinomaHistopathologyMinimally invasiveParenchymal sparing surgeryR1 vascular

Identifiers

PMID39681679
PMCPMC11794367

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.