Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors.
BACKGROUND
The number of reported laparoscopic hepatectomies for liver malignancy is increasing, but comparative data on the survival outcomes between the patients who have undergone laparoscopic hepatectomy versus open surgery are still lacking.


METHODS
We compared 31 laparoscopic liver resections with 31 open liver resections in a pair-matched retrospective analysis with the aim of evaluating the intraoperative hazards, recovery, and survival 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.


RESULTS
Thirty cases in the laparoscopic group were performed successfully while one case was converted to open surgery due to intraoperative hemorrhage. The length of hospital stay was 7.5 (5-15) days, which was 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 lower than those in open group but without significant difference. There were no operative complications and no deaths in the laparoscopic group. The mean and median survival times of laparoscopic group were 59.3 and 70 months, compared with 49.4 and 60 months in the open group, respectively. The 1-, 3-, 5-year survival rates in the laparoscopic group were, respectively, 96.55%, 60.47%, and 50.40%, and 96.77%, 68.36%, and 50.64% in the open group. By log-rank test, these two survival curves were not significantly different (p = 0.8535).


CONCLUSIONS
This study shows that laparoscopic hepatectomy for liver malignancy in selected patients is a safe, effective, and oncologically efficient procedure with better short-term results and similar survival outcomes to open hepatectomy for liver malignancy after midterm follow-up.
Cai
Xiu Jun
XJ
Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, No. 3, East Qinchun Road, Hangzhou, 310016, PR China. wenhao_lu@126.com
Yang
Jin
J
Yu
Hong
H
Liang
Xiao
X
Wang
Yi Fan
YF
Zhu
Zi Yi
ZY
Peng
Shu Yong
SY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate