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Comparison of clinical outcomes of laparoscopic versus open surgery for recurrent hepatocellular carcinoma: a meta-analysis

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Abstract

Background

The purpose of this study is to compare the clinical outcomes of laparoscopic liver resection versus open liver resection for recurrent hepatocellular carcinoma (RHCC).

Methods

Published studies which investigated laparoscopic versus open liver resection for RHCC were identified, and meta-analysis was used for statistical analysis.

Results

Six studies were analyzed by meta-analysis method, and cumulative 335 cases were included in this study. Laparoscopic liver resection was performed in 145 cases, and open liver resection was performed in 190 cases. Meta-analysis showed that there was no difference in operative time and 90-day mortality between the laparoscopic group and the open group (p = 0.06 and p = 0.06 respectively); Nevertheless, compared with the open group, the laparoscopic group resulted in significantly lower rate of in-hospital complication (p < 0.0001), much less blood loss (p < 0.0001) and shorter postoperative hospital stay (p = 0.002).

Conclusion

Laparoscopic liver resection for RHCC offers a benefit of lower in-hospital complication rate, less blood loss, shorter postoperative hospital stay, while similar operative time and 90-day mortality as the open liver resection. Laparoscopic liver resection is feasible with satisfactory postoperative outcomes and can be a safe alternative treatment strategy to open procedure for RHCC.

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Funding

This work was supported by the National Natural Science Foundation of China, Beijing (Grant Nos. 81703767, W.C. and 81602489, B. C.) and the Hunan Natural Science Foundation of China, Changsha (Grant No. 2019JJ50891, W.C).

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Author notes

  1. Wenwu Cai and Zhide Liu have contributed equally to this article.

Authors and Affiliations

  1. Department of General Surgery, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People’s Republic of China

    Wenwu Cai, Zhide Liu, Weichang Zhang, Da Tang & Qinglong Li

  2. Department of Ophthalmology, Second Xiangya Hospital, Central South University, Number 139, Renmin Road, Changsha, 410011, Hunan, People’s Republic of China

    Yangyan Xiao

  3. Department of Oncology, Peking University Shenzhen Hospital, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, People’s Republic of China

    Boran Cheng

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  1. Wenwu Cai
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Correspondence to Qinglong Li.

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Drs. Wenwu Cai, Zhide Liu, Yangyan Xiao, Weichang Zhang, Da Tang, Boran Cheng and Qinglong Li have no conflicts of interest or financial ties to disclose.

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Cai, W., Liu, Z., Xiao, Y. et al. Comparison of clinical outcomes of laparoscopic versus open surgery for recurrent hepatocellular carcinoma: a meta-analysis. Surg Endosc 33, 3550–3557 (2019). https://doi.org/10.1007/s00464-019-06996-4

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  • DOI: https://doi.org/10.1007/s00464-019-06996-4

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