Effectivensee And Safety Of Laparoscopic Versus Open Left Hepatectomy For Primary Cancer:a Meta-analysis

Background Hepatocellular carcinoma(HCC) is one of the most common malignant tumor worldwide,especially in Aisa.China is developing one of the highest incidence of hepatocellular carcinoma.In China,about11000people died of HCC every year,which composed about45%of death cases worldwide.laparoscopic hepatectomy combining several techniques with evidence-based adjustments, has shown its effectiveness to accelerate recovery, reduce morbidity and shorten hospital stay in many operations.Objective To evaluate the effectiveness and safety of laparoscopic hepatectomy(LH) versus open hepatectomy(OH) for Primary Cancer.Methods Databases including ISI Web of Knowledge, MEDLINE, EMbase, PubMed, CNKI, VIP and WANFANG were searched to collect clinical trials on laparoscopic versus conventional open hepatectomy. Relevant proceedings and references of the included studies were also retrieved manually. According to the inclusion criteria, two reviewers independently screened literature, extracted data and assessed quality. Then meta-analysis was conducted using RevMan5.0software.Results No randomized controlled trials were collected, and a total of10clinical concurrent controlled trials involving537patients were included finally. The results of meta—analysis showed that:1) Laparoscopic hepatectomy can be more safyty. the laparoscopic group was lower in the intraoperative blood loss[WMD=-83.3,95%CI (-124.3,-42.3),P<0.0001], less ues of portal clamping[OR=0.17,95%CI (0.06,0.52), P=0.002], less hospital stays[WMD=-4.85,95%CI(-6.31,-3.38),P<0.00001]or postoperative complications[OR=0.3,95%CI (0.16,0.59), P=0.0004].2) There was no significant difierenc of tumor recurrence[OR=1.05,95%CI (0.6,1.85), P=0.87] and1-,3-and5-year recurrence-free survival[OR=1.89,95%CI (0.96,3.7), P=0.16; OR=1.57,95%CI (0.94,2.61), P=0.18; OR=0.97,95%CI (0.54,1.77), P=0.93]andl-,3and5-year pooled of overall survival [OR=1.40,95%CI (0.76,2.56), P=0.28; OR=1.15,95%CI (0.74,1.81), P=0.53; OR=0.91,95%CI (0.57,1.45), P=0.68]between two groups.Conclusion Compare with OH, LH may have short-term advantages in terms of blood loss and postoperative morbidity for HCC. Both procedures have similar long-term outcomes.