Impact of laparoscopic liver resection with 0-mm surgical-adjacency to vasculature on short-term oncologic outcomes in hepatocellular carcinoma

The impact of surgical margins on surgical margin recurrence (SMR) in laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC) remains unclear. This study investigated the association between LLR with a 0-mm surgical margin (SM0) of the vasculature and SMR. This single-center retrospective cohort study enrolled patients with HCC who underwent initial LLR from January 2018 to December 2022—categorized into positive surgical margin (SM (+)), negative surgical margin (SM (−)), SM0-vascular, and SM0-parenchymal groups—with follow-up every three months until death or August 2024. The primary and secondary endpoints were the SMR ratio and cumulative recurrence rate. Of the 144 patients, 4, 99, 32, and 9 underwent LLR with SM (+), SM (−), SM0- vascular , and SM0- parenchymal , respectively. The SM0- vascular group had more multiple tumors ( p = 0.02) and underwent more Pringle maneuvers (7 vs. 5; p = 0.03) than the SM (−) group. The 3 year-SMR and -cumulative recurrence rates were not significantly different between the SM (−) and SM0- vascular groups (5 % vs. 6 %, p = 0.46; 32 % vs. 46 %, p = 0.09, respectively). An LLR with a 0-mm surgical margin for the vasculature may be an acceptable treatment strategy for the local control of HCC.