Study On Laparoscopic Hepatectomy Of Hepatocellular Carcinoma

Introduction:Laparoscopic minimally invasive surgery is a major trend in the development of surgery in the twenty-first Century.It is characterized by small scar and fast recovery thereby turning in the patient's own advantage.However,due to the complexity of the anatomical structure of the liver and limited equipment,some restrictions could still be encountered while performing a laparoscopic hepatectomy:performing full liver exploration using the laparoscope proper control of bleeding,operating with the instruments,locating of deep-lying tumors,limited space and visual field to work during surgery are challenging.New techniques are being implemented to make it a relatively safe method.It was first used in the treatment of benign tumors of the liver and then gradually was applied to the treatment of malignant liver tumors.Our aim is to compare and analyze the advantages and drawback of laparoscopic and open hepatectomy.Methods:From 2011 to 2015,a total of 14 relevant articles were selected to evaluate patients with HCC:(1)Using the RevMan software from Cochrane,a forest plot was used to represent the data to compare the post-operative complications between laparoscopic hepatectomy(LH)and open hepatectomy(OH).(2)Using the prism software,the mean peri-operative blood loss,operating time and length of hospital stay between the two above groups were compared.Results:(1)When compared with OH,LH had a lower severity of post-operative complication with an odd ratio value is 0.39.The forest plot favors a higher post-operative complication in OH groups of odd ratio= 0.61;heterogeneity:Chi2=16.27,df = 9(p value= 0.06,statistically significant)and 12 = 45%.Test for overall effect Z-7.10.(2)The length of hospital stay was shorter in LH patients and the mean estimated blood loss was also lower in LH groups.But,only the mean operative time was higher for LH.However,no big difference was noted on the 5-year survival rate and recurrence rate.Conclusion:Laparoscopic hepatectomy confers the widely accepted benefits of laparoscopic surgery,namely severity of complication,length of hospital stay and blood loss.Moreover,with comparatively less trauma and a small scar,the objective of minimally invasive surgery has been achieved.Operative time is expected to decrease with new techniques and experience.Laparoscopic liver resection is a safe and feasible procedure for HCC.