A meta-analysis: laparoscopic versus open liver resection for large hepatocellular carcinoma.

ABSTRACT

BACKGROUND: The indication of laparoscopic liver resection (LLR) for treating large hepatocellular carcinoma (HCC) is controversial. In this study, we compared the short-term and long-term outcomes of LLR and open liver resection (OLR) for large HCC. MATERIAL AND METHODS: We searched eligible articles about LLR versus OLR for large HCC in PubMed, Cochrane Library, and EMBASE and performed a meta-analysis. RESULTS: Eight publications involving 1,338 patients were included. Among them, 495 underwent LLR and 843 underwent OLR. The operation time was longer in the LLR group (MD 22.23, 95% CI 4.14-40.33, p = 0.02). but the postoperative hospital stay time was significantly shorter (MD -4.88, CI -5.55 to -4.23, p < 0.00001), and the incidence of total postoperative complications and major complications were significantly fewer (OR 0.49, 95% CI0.37-0.66, p < 0.00001; OR 0.54, 95% CI0.36 - 0.82, p = 0.003, respectively). Patients in the laparoscopic group had no significant difference in intraoperative blood loss, intraoperative transfusion rate, resection margin size, R0 resection rate, three-year overall survival (OS) and three-year disease-free survival (DFS). CONCLUSION: LLR for large HCC is safe and feasible. This surgical strategy will not affect the long-term outcomes of patients.