Meta-analysis of laparoscopic versus open resection for hepatocellular carcinoma.
BACKGROUND
Laparoscopic liver resection (LLR) remains to be established as a safe and effective alternative to open liver resection (OLR) for hepatocellular carcinoma (HCC).


OBJECTIVE
The aim of this meta-analysis is to compare laparoscopic versus open resection for HCC with regard to perioperative and oncologic outcomes.


METHODS
A literature search was performed to identify comparative studies reporting outcomes for both laparoscopic and open resection for HCC. Pooled odds ratios (OR) and weighted mean differences (WMD with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.


RESULTS
Ten nonrandomized controlled studies matched the selection criteria and reported on 494 subjects, of whom 213 underwent LLR and 281 underwent OLR for HCC. Compared with the perioperative results of open surgery, reports on laparoscopic resection indicate potentially favourable outcomes in terms of operative blood loss (WMD: -160.57, 95% CI: -246.49 to -74.66), blood transfusion requirement (OR: 0.39, 95% CI: 0.18 to 0.86), postoperative morbidity (OR: 0.48, 95% CI: 0.29 to 0.78), and length of hospital stay (WMD: -5.53, 95% CI: -7.89 to -3.16). Concerning the oncologic outcomes, there was no difference between groups in surgical margin, overall survival and disease-free survival.


CONCLUSIONS
LLR for HCC is superior to the OLR in terms of its perioperative results and does not compromise the oncological outcomes. Therefore, LLR may be an alternative choice for treatment of HCC.
Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China. zhouyms@yahoo.com.cn
Yan-Ming
YM
Zhou
Wen-Yu
WY
Shao
Yan-Fang
YF
Zhao
Dong-Hui
DH
Xu
Bin
B
Li
D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008099:Liver / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
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