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Meta-Analysis of Laparoscopic Versus Open Resection for Hepatocellular Carcinoma

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Abstract

Background

Laparoscopic liver resection (LLR) remains to be established as a safe and effective alternative to open liver resection (OLR) for hepatocellular carcinoma (HCC).

Aims

The aim of this meta-analysis is to compare laparoscopic versus open resection for HCC with regard to perioperative and oncologic outcomes.

Methods

A literature search was performed to identify comparative studies reporting outcomes for both laparoscopic and open resection for HCC. Pooled odds ratios (OR) and weighted mean differences (WMD with 95% confidence intervals (95% CI) were calculated using either the fixed effects model or random effects model.

Results

Ten nonrandomized controlled studies matched the selection criteria and reported on 494 subjects, of whom 213 underwent LLR and 281 underwent OLR for HCC. Compared with the perioperative results of open surgery, reports on laparoscopic resection indicate potentially favourable outcomes in terms of operative blood loss (WMD: −160.57, 95% CI: −246.49 to −74.66), blood transfusion requirement (OR: 0.39, 95% CI: 0.18 to 0.86), postoperative morbidity (OR: 0.48, 95% CI: 0.29 to 0.78), and length of hospital stay (WMD: −5.53, 95% CI: −7.89 to −3.16). Concerning the oncologic outcomes, there was no difference between groups in surgical margin, overall survival and disease-free survival.

Conclusions

LLR for HCC is superior to the OLR in terms of its perioperative results and does not compromise the oncological outcomes. Therefore, LLR may be an alternative choice for treatment of HCC.

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Acknowledgments

The authors thank U. Sarpel and colleagues for kindly providing more details about their reported cases.

Author information

Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China

    Yan-Ming Zhou, Dong-Hui Xu & Bin Li

  2. Department of Liver Surgery, First Affiliated Hospital, Nanjing Medical University, Nanjing, China

    Wen-Yu Shao

  3. Department of Health Statistics, Second Military Medical University, Shanghai, China

    Yan-Fang Zhao

Authors
  1. Yan-Ming Zhou
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  3. Yan-Fang Zhao
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  4. Dong-Hui Xu
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  5. Bin Li
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Corresponding author

Correspondence to Bin Li.

Additional information

Yan-Ming Zhou and Wen-Yu Shao contributed equally to this work.

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Zhou, YM., Shao, WY., Zhao, YF. et al. Meta-Analysis of Laparoscopic Versus Open Resection for Hepatocellular Carcinoma. Dig Dis Sci 56, 1937–1943 (2011). https://doi.org/10.1007/s10620-011-1572-7

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  • DOI: https://doi.org/10.1007/s10620-011-1572-7

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