Comparison Of Single-Access Transumbilical Laparoscopic Left Lateral Resection Versus Traditional Laparoscopic Liver Resection For Liver Tumors

Background. Although laparoscopic liver resection (LLR) is widely accepted, safer and more feasible techniques are required. Single-access transumbilical laparoscopy (SATL) is one of them, which need more trials to demonstrate its feasibility and superiority. In this study, we aim to summarize our experience of SATL and compare its related surgical outcomes with traditional multi-access LLR for left lateral resection in liver tumor patients in China to make a better learning curve.Methods.33 patients were included in our study.16 cases were performed left lateral resection by using SATL and 17 cases were by traditional LLR. The demographic profile, intraoperative parameters, and postoperative parameters were shown and compared between the two groups. For the better support to our argument, we made some learning curves in the analysis process.Results. Neither conversion to open surgery nor insertion of supplementary trocars was necessary. No drain was needed. The mean operating time(99.38±19.91min versus 124.41±40.35min, p<0.05) between 2 groups showed some statistical sinificance. The post-operation hospital stay in SATL group was a little shorter(7.68±2.36 days versus 8.76±1.79 days, p>0.05). And the learning curves showed that they would be gradually reduced and be a stable level as the cases increased. The intraoperative blood loss in the SATL group were also less, though there was no significant statistical difference between the two groups. The intra-operative cost was higher than TLLR’s(23821.93±4206.24yuan versus 19408.05±3477.09yuan, p<0.05), but the total cost(47259.94±5582.83yuan versus 45538.44±5849.21yuan, p>0.05) was almost the same. There is no significant difference between the two groups in other parameters, complications and liver function.Conclusions. SATL is a safe and feasible procedure with some good learning curves, which might decrease blood loss, and shorten procedure time and hosptal stay with accumulated experience and selected cases, especially in the left lateral liver lesions. It shows some excellent surgical outcomes and economic benefits. Though potentially post-operative pain were not so different, the cosmetic outcome was still worthy to be considered. The SATL could be recommended as the new gold standard for left lateral liver lesions. But, still, more studies with larger sample size and longer follow-up are needed.