Clinical Study Of Laparoscopic Hepatectomy For Malignant Liver Tumors

Objective To evaluate the feasibility,safety,and oncological adequacy of laparoscopic hepatectomy for malignant liver tumors.Methods We compared 31 laparoscopic liver resections with 31 open liver resections in a pair-matched analysis with the aim of evaluating the intraoperative hazards,recovery and the long-term outcomes of these procedures for liver cancer.The laparoscopic group and the open group were matched for age, sex,the size and location of the tumor,and the presence or absence of cirrhosis.A total of 17 partial resections,8 segmentectomies,3 left lateral lobe hepatectomy,and 3 left hemihepatectomy were performed in each group.Results Thirty cases in the laparoscopic group were performed successfully except for one case which was converted open surgery due to intraoperative hemorrhage.The length of hospital stay and the number of postoperative days until oral intake in the laparoscopic group were 7.5(5-15)days and 1.5 (1-3)days,respectively,which were significantly shorter than those in open group(p＜0.01).The mean operative time and blood loss in the laparoscopic group were 140.1(60—380)min and 502.9(50—2000)ml respectively,which were shorter than those in open group but without significant difference.There were no operative complications and no deaths in laparoscopic group.The mean follow-up lengths for the laparoscopic and open groups were 29.77(10-103)and 29.9(8-74)months, respectively.The mean and median survival times of laparoscopic group were 59.34 and 70 months,compared with49.4 and 60 months in the open group.The 1-,3-,5-year survival rates in the laparoscopic group were 96.55%,60.47%, 50.40%and 96.77%,68.36%,50.64%in the open group.By log-rank test,these two survival curves were not significantly different(p=0.8535).Conclusion Our study shows that laparoscopic hepatectomy for liver malignancy in selected patients is a safe, effective and oncologically effective procedure with better short-term results and similar survival outcomes when compared to those in the open group after midterm follow-up.