title: Long-term survival analysis of pure laparoscopic versus open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a single-center experience.
abstract: BACKGROUND
  Laparoscopic liver resection has been reported as a safe and effective approach to the management of liver cancer. However, studies of long-term outcomes regarding tumor recurrence and patient survival in comparison with the conventional open approach are limited. The aim of this study was to analyze the survival outcome of laparoscopic liver resection versus open liver resection.
  
  
  METHODS
  Between October 2002 and September 2009, 32 patients underwent pure laparoscopic liver resection for hepatocellular carcinoma (HCC). Case-matched control patients (n = 64) who received open liver resection for HCC were included for comparison. Patients were matched in terms of cancer stage, tumor size, location of tumor, and magnitude of resection. Immediate operation outcomes, operation morbidity, disease-free survival, and overall survival were compared between groups.
  
  
  RESULTS
  With the laparoscopic group compared with the open resection group, operation time was 232.5 minutes versus 204.5 minutes (P = 0.938), blood loss was 150 mL versus 300 mL (P = 0.001), hospital stay was 4 days versus 7 days (P < 0.0001), postoperative complication was 2 (6.3%) versus 12 (18.8%) (P = 0.184), disease-free survival was 78.5 months versus 29 months (P = 0.086), and overall survival was 92 months versus 71 months (P = 0.142). The disease-free survival for stage II HCC was 22.1 months versus 12.4 months (P = 0.075).
  
  
  CONCLUSIONS
  Laparoscopic liver resection for HCC is associated with less blood loss, shorter hospital stay, and fewer postoperative complications in selected patients with no compromise in survival.
authors.affiliation: Department of Surgery, The University of Hong Kong, Hong Kong, China. tantocheung@hotmail.com
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.forename: Wai Key
authors.initials: WK
authors.lastname: Yuen
authors.forename: Kenneth S H
authors.initials: KS
authors.lastname: Chok
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Jenkins
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.forename: Sheung Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000601:surgery; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000639:trends; D008103:Liver Cirrhosis / Q000150:complications* / Q000601:surgery; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013997:Time Factors