Open versus laparoscopic liver resection: looking beyond the immediate postoperative period.
BACKGROUND
Laparoscopic liver resection for malignant disease has shown short-term benefit. This study aimed to compare in-house, 30-day, and 1-year morbidity between laparoscopic and open liver resections.


METHODS
The charts for all patients who underwent liver resection for malignant disease between April 2006 and October 2009 were reviewed. Patient, operative, and outcomes data at 30 days and 1 year were collected.


RESULTS
For 76 patients, 49 open and 27 laparoscopic resections were performed. The two groups were similar in terms of age, gender, body mass index (BMI), extent of liver resection, use of ablation therapy, and tumor pathology (P > 0.05). The laparoscopic group had less blood loss (P = 0.004) and shorter hospital stays (P = 0.002). During their hospital stay, patients treated laparoscopically had fewer complications, but the difference was not significant. Home disposition was similar in the laparoscopic (96%) and open (90%) groups. More patients were readmitted at 30 days (2 vs. 9; P = 0.31) and 1 year (4 vs. 19; P = 0.04) in the open group. The all-cause 1-year mortality rates were similar between the laparoscopic and open groups (14.8% vs. 10.2%).


CONCLUSIONS
The benefits of laparoscopic liver resection may extend beyond the initial postoperative period, with fewer readmissions despite shorter hospital stays. This also may suggest lower long-term hospital costs.
Division of Surgical Oncology, Department of Surgery, Wright State University Boonshoft School of Medicine, One Wyoming Street, WCHE 7000, Dayton, OH 45409, USA.
Joshua D
JD
Gustafson
Justin P
JP
Fox
James R
JR
Ouellette
Minia
M
Hellan
Paula
P
Termuhlen
Mary C
MC
McCarthy
Thavam
T
Thambi-Pillai
D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D017115:Catheter Ablation / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D017052:Hospital Mortality; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000401:mortality*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011184:Postoperative Period; D016896:Treatment Outcome