Objectives: To evaluate the effect of Pringle maneuver time on tumor recurrence following liver resection in patients with hepatocellular carcinoma (HCC).
Methods: In this single-center study, we retrospectively evaluated the effect of Pringle maneuver time on HCC recurrence over a 10-year period from 1999 to 2008 using a Cox regression analysis.
Results: This study enrolled a total of 2,368 patients. A Pringle maneuver time of 15 min was associated with HCC recurrence (log likelihood ratio test, P = 0.001). A Pringle maneuver time less than 15 min was not a significant risk factor for HCC recurrence (hazard ratio, HR = 0.97, P = 0.708). However, a Pringle maneuver time greater than 15 min was an independent predictor of HCC recurrence (HR = 1.41, P < 0.001). The patients who underwent the Pringle maneuver for over 15 min had lower overall survival (OS) and recurrence-free survival (RFS) than did those who either did not undergo the maneuver or underwent the maneuver for less than 15 min (both P < 0.001).
Conclusions: These results suggest that a longer duration of the Pringle maneuver increases the risk of tumor recurrence in patients with HCC. However, a shorter duration of the Pringle maneuver decreases this risk. J. Surg. Oncol. 2016;114:112-118. © 2016 Wiley Periodicals, Inc.
Keywords: Pringle maneuver; hepatocellular carcinoma; ischemia time; recurrence.
© 2016 Wiley Periodicals, Inc.