title: Laparoscopic versus open major hepatectomy for hepatocellular carcinoma: a matched pair analysis.
abstract: BACKGROUND
  Laparoscopic major hepatectomy (LMH) for hepatocellular carcinoma (HCC) is currently perceived a complex and challenging laparoscopic procedure and is limited to a few expert teams. This study analyzed the short- and long-term outcomes of LMH for HCC compared with open hepatectomy.
  
  
  METHODS
  From January 2006 to May 2014, 38 patients underwent LMH for HCC (10 left and 28 right hepatectomy). They were matched and compared to 38 patients (10 left and 28 right hepatectomy) who underwent a conventional open approach. Short-term operative and postoperative outcomes as well as long-term outcomes, including disease-free survival and overall survival rates, were evaluated.
  
  
  RESULTS
  Patients were well matched for several preoperative factors. Overall complication rates were significantly higher for the open group. No significant difference was seen in 3-year overall survival between the open and laparoscopic groups (69.2 vs. 73.4 %; p = 0.951). A trend toward better 3-year disease-free survival after laparoscopy was observed (29.7 vs. 50.3 %; p = 0.219), even though the difference did not reach statistical significance. The same trend was seen in subgroup analyses of right and left hepatectomy.
  
  
  CONCLUSIONS
  This study shows the feasibility of LMH for HCC compared to open hepatectomy in regard to both short- and long-term outcomes. LMH offers many advantages commonly attributed to laparoscopy and is well suited for HCC with cirrhosis when performed by experienced surgeons.
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de L'Hôpital, 75013, Paris, France. komasho8@gmail.com.
authors.forename: Shohei
authors.initials: S
authors.lastname: Komatsu
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.|Université Pierre et Marie Curie, Paris, France.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Brustia
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Goumard
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Perdigao
authors.affiliation: Department of Hepatobiliary and Liver Transplantation, Hôpital Beaujon, Assistance Publique Hôpitaux de Paris, Paris, France.|Université Paris VII, Clichy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Soubrane
authors.affiliation: Department of Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.|Université Pierre et Marie Curie, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Scatton
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008103:Liver Cirrhosis / Q000150:complications; D017093:Liver Failure / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Hepatocellular carcinoma; Laparoscopy; Long-term outcome; Major hepatectomy; Matched pair analysis; Short-term outcome