Abstract:
Objective To compare the short-and long-term outcomes of laparoscopic liver resection (LLR) with those of open liver resection (OLR) for hepatocellular carcinoma (HCC).
Methods Clinical data from patients who suffered from HCC and received LLR or OLR from January 2013 to May 2016 in The First Affiliated Hospital of Fujian Medical University were analyzed restrospectively. To overcome selection bias, a 1:1 match was performed via a case-control study. After case-control matching was completed, 105 patients were included in each group. Short-term outcomes of operation and postoperation as well as long-term outcomes, including diseasefree survival and overall survival rates, were evaluated. Relevant statistical methods were used for statistical analysis.
Results The postoperative hospital stay of the laparoscopic group was shorter (8.68±2.82 vs. 10.61±2.95 days, P < 0.01) and its use of portal triad clamping was less (20.0% vs. 41.0%, P < 0.01) than those of the open group. The abdominal drainage tube of the laparoscopic group was also removed at an earlier time than that of the open group (4.45±2.53 vs. 5.40±2.43 days, P < 0.01). The 1-, 2-, and 3-year overall survival rates of the laparoscopic group were 96.88%, 87.54%, and 79.50%, respectively. By comparison, the 1-, 2-, and 3-year overall survival rates of the open group were 94.91%, 86.29%, and 76.37%, respectively (P=0.670). The 1-, 2-, and 3-year disease-free survival rates of the laparoscopic group were 72.09%, 60.16%, and 52.08%, respectively, while the 1-, 2-, and 3-year disease-free survival rates of the open group were 69.48%, 56.50%, 48.13%, respectively (P=0.388).
Conclusion LLR is a safe and feasible procedure. LLR in the selected patients with HCC showed similar long-term outcomes to those of OLR. The postoperative hospital stay of these patients who underwent LLR was shorter and their use of portal triad clamping was less than those of the patients who received OLR. The abdominal drainage tube of the former was also removed at an earlier time than that of the latter. Therefore, the short-term outcomes of LLR were better than those of OLR.