title: Laparoscopic versus open liver resection: a meta-analysis of long-term outcome.
abstract: BACKGROUND
  Laparoscopic liver resection is growing in popularity, but the long-term outcome of patients undergoing laparoscopic liver resection for malignancy has not been established. This paper is a meta-analysis and compares the long-term survival of patients undergoing laparoscopic (LHep) versus open (OHep) liver resection for the treatment of malignant liver tumours.
  
  
  METHODS
  A PubMed database search identified comparative human studies analysing LHep versus OHep for malignant tumours. Clinical and survival parameters were extracted. The search was last conducted on 18 March 2012.
  
  
  RESULTS
  In total, 1002 patients in 15 studies were included (446 LHep and 556 OHep). A meta-analysis of overall survival showed no difference [1-year: odds ratio (OR) 0.71, 95% confidence interval (CI) 0.42 to 1.20, P = 0.202; 3-years: OR 0.76, 95% CI 0.56 to 1.03, P = 0.076; 5-years: OR 0.8, 95% CI 0.59 to 1.10, P = 0.173]. Subset analyses of hepatocellular carcinoma (HCC) and colorectal metastases (CRM) were performed. There was no difference in the 1-, 3-, and 5-year survival for HCC or in the 1-year survival for CRM, however, a survival advantage was found for CRM at 3 years (LHep 80% versus OHep 67.4%, P = 0.036).
  
  
  CONCLUSIONS
  Laparoscopic surgery should be considered an acceptable alternative for the treatment of malignant liver tumours.
authors.affiliation: Department of Surgery, Jersey Shore University Medical Center; Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
authors.forename: Kevin Ryan
authors.initials: KR
authors.lastname: Parks
authors.forename: Yen-Hong
authors.initials: YH
authors.lastname: Kuo
authors.forename: John Mihran
authors.initials: JM
authors.lastname: Davis
authors.forename: Brittany
authors.initials: B
authors.lastname: O' Brien
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Hagopian
mesh_terms: D002277:Carcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D019317:Evidence-Based Medicine; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006801:Humans; D010535:Laparoscopy / Q000401:mortality; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome