Clinical Outcomes Of Laparoscopic Hepatectomy And Open Hepatectomy For Hepatocellular Carcinoma:a Meta-analysis

Objective Systematic and comprehensive evaluation of short andlong term efficacy and safety of Laparoscopic hepatectomy (LH) and openhepatectomy (OH) for hepatocellular carcinoma(HCC).Methods Using a defined search strategy, randomized controlledtrials, controlled clinical trials of laparoscopic hepatectomy (LH) and openhepatectomy (OH) for hepatocellular carcinoma(HCC). All data wereanalyzed using RevMan5.1.Results Twelve studies comprising980patients were eligible forinclusion，of whom391underwent LH and589underwent OH.Themeta-analysis showed that:⑴Operative time There were no significantdifferences between the two treatment groups [WMD=3.34,95%Cl(-19.17,25.85) P=0.77]⑵B lood transfusion There were significantdifferences in blood transfusion between the two treatment groups,LH needfewer trsnsfusions than OH [OR=0.48,95%Cl(0.26,0.89) P=0.02]⑶Hospital stay There were significant differences in duration of hospitalstay between the two groups, LH need shorter hospital stay than OH [WMD=-4.27,95%Cl(-6.18,-2.37)P <0.0001]⑷Intraoperative blood loss:there were significant differences in intraoperative blood loss between thetwo groups, LH have less blood loss than OH [WMD=-242.5,95%Cl(-458.67,-26.34) P=0.03]⑸Complications There were significantdifferences between the two treatment groups， LH have lowerComplications than OH [OR=0.48,95%Cl(0.31,0.75) P=0.001]⑹Surgerymargin There were no significant differences between the two treatmentgroups [WMD=0.76,95%Cl(-0.03,1.56) P=0.06]⑺Mortality There weresignificant differences between the two treatment groups，LH have lowerMortality than OH[OR=0.24,95%Cl(0.07,0.86) P=0.03]⑻1,3yearoverall survival and1,3,5year disease-free survival There were nosignificant differences between the two treatment groups [OR=1.09,95%Cl(0.70,1.68) P=0.71][OR=1.31,95%Cl(0.95,1.80) P=0.09][OR=1.52,95%Cl(0.97,2.37) P=0.07][OR=0.94,95%Cl(0.65,1.35) P=0.73][OR=1.14,95%Cl(O.75,1.73) P=0.55];⑼5year disease-free survival There weresignificant differences between the two treatment groups in terms of5yeardisease-free survival[OR=1.61,95%Cl(1.18,2.19) P=0.003]Conclusions Laparoscopic treatment of liver cancer as a minimallyinvasive surgery compared to open surgical resection, with less trauma,quicker recovery, less blood loss and fewer postoperative complications,and is expected to become patient’s preferred treatment programs.