Laparoscopic Versus Open Hepatectomy For Hepatocellular Carcinoma In Patients With Cirrhosis:Analysis Of Security And Prognosis

INTRODUCTION:Liver resection is generally recognized as the best way to obtain a radical cure of hepatocellular carcinoma, Laparoscopic hepatectomy has gradually developed into a safe and.ffective approach. However, relevant studies on the hepatocellular carcinoma merges with cirrhosis are still limited. The aim of this study was to analyze the security and long-term outcome of laparoscopic liver resection versus open liver resection.PATIENTS AND METHODS:Between January2001and November2010,19cases who underwent pure laparoscopic hepatectomy in Sir Run Run Shaw Hospital and confirmed hepatocellular carcinoma with liver cirrhosis pathologically were chosen as experimental group(n=19). Case-matched control patients (n=19) who received open hepatectomy for HCC in the corresponding period were included for comparison, named (OH). Patients were matched in terms of gender, age, cancer stage, tumor size, location of tumor, and magnitude of resection. Immediate operation outcome and long-term survival were compared between groups.RESULTS:There is not perioperative death in both groups. By comparing we did not find significant difference between Laparoscopic group and Open group in gender, age, tumor size, BMI, tumor location, tumor size, Barcelona stage and other clinical data. Analyse the laparoscopic group versus the open resection group, mean operation time were136.52±44.75minutes versus146.84±69.47minutes (P=0.618). mean Blood loss were310.53±312.22ml versus631.58±687.83ml(P=0.086).laparotomy group. The incidence of postoperative complications were31.6%(n=6) versus42.1%(n=8)(P=0.688). Average hospital stays were9.21±4.53days versus11.11±4.54days (P=0.199).1year,2years,3years survival rates of Laparoscopic and Open group were100%,89%,78%and100%,95%89%respectively (P=0.484), and1year,2years,3years disease-free survival rates were84%,79%,79%and84%,79%,74%respectively (P=0.133).CONCLUSIONS:Laparoscopic hepatectomy for HCC merged with cirrhosis is associated with less blood loss, shorter hospital stay in selected patients with no compromise in postoperative survival.