A meta-analysis: laparoscopic versus open liver resection for large hepatocellular carcinoma
Zha Peng, Zhuangrong Zhu, Chengyi He, Hai Huang
Abstract
Background:The indication of laparoscopic liver resection (LLR) for treating large hepatocellular carcinoma (HCC) is controversial.In this study, we compared the short-term and long-term outcomes of LLR and open liver resection (OLR) for large HCC.Material and methods: We searched eligible articles about LLR versus OLR for large HCC in PubMed, Cochrane Library, and EMBASE and performed a meta-analysis.Results: Eight publications involving 1,338 patients were included.Among them, 495 underwent LLR and 843 underwent OLR.The operation time was longer in the LLR group (MD: 22.23, 95% CI: 4.14-40.33,p 0.02).but the postoperative hospital stay time was significantly shorter (MD : -4.88, CI: -5.55 to -4.23, p < 0.00001), and the incidence of total postoperative complications and major complications were significantly fewer (OR: 0.49, 95% CI:0.37-0.66,p < 0.00001; OR: 0.54, 95% CI:0.36 -0.82, p 0.003, respectively).Patients in the laparoscopic group had no significant difference in intraoperative blood loss, intraoperative transfusion rate, resection margin size, R0 resection rate, three-year overall survival (OS) and three-year disease-free survival (DFS).Conclusion: LLR for large HCC is safe and feasible.This surgical strategy will not affect the longterm outcomes of patients.