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Laparoscopic versus open major liver resection for hepatocellular carcinoma: systematic review and meta-analysis of comparative cohort studies.
Wang, Zi-Yu; Chen, Qing-Lian; Sun, Ling-Ling; He, Shu-Ping; Luo, Xiao-Fen; Huang, Li-Shuang; Huang, Jun-Hai; Xiong, Cheng-Ming; Zhong, Chong.
Afiliação
  • Wang ZY; Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, 16 Airport Road, Guangzhou, 510405, China.
  • Chen QL; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
  • Sun LL; The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
  • He SP; Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, 16 Airport Road, Guangzhou, 510405, China.
  • Luo XF; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
  • Huang LS; The First Clinical Medical School of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
  • Huang JH; Department of Oncology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
  • Xiong CM; Department of Hepatobiliary Surgery, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, 16 Airport Road, Guangzhou, 510405, China.
  • Zhong C; Lingnan Medical Research Center, Guangzhou University of Chinese Medicine, Guangzhou, 510405, China.
BMC Cancer ; 19(1): 1047, 2019 Nov 06.
Article em En | MEDLINE | ID: mdl-31694596
ABSTRACT

BACKGROUND:

The application of laparoscopic liver resection (LLR) has expanded rapidly in recent decades. Although multiple authors have reported LLR shows improved safety and efficacy in treating hepatocellular carcinoma (HCC) compared with open liver resection (OLR), laparoscopic (LMLR) and open (OMLR) major liver resections for HCC treatment remain inadequately evaluated. This work aimed to test the hypothesis that LMLR is safer and more effective than OMLR for HCC.

METHODS:

Comparative cohort and registry studies on LMLR and OMLR, searched in PubMed, the Science Citation Index, EMBASE, and the Cochrane Library, and published before March 31, 2018, were collected systematically and meta-analyzed. Fixed- and random-effects models were employed for generating pooled estimates. Heterogeneity was assessed by the Q-statistic.

RESULTS:

Nine studies (1173 patients) were included. Although the pooled data showed operation time was markedly increased for LMLR in comparison with OMLR (weighted mean difference [WMD] 74.1, 95% CI 35.1 to 113.1, P = 0.0002), blood loss was reduced (WMD = - 107.4, 95% CI - 179.0 to - 35.7, P = 0.003), postoperative morbidity was lower (odds ratio [OR] 0.47, 95% CI 0.35 to 0.63, P <  0.0001), and hospital stay was shorter (WMD = - 3.27, 95% CI - 4.72 to - 1.81, P <  0.0001) in the LMLR group. Although 1-year disease-free survival (DFS) was increased in patients administered LMLR (OR = 1.55, 95% CI 1.04 to 2.31, P = 0.03), other 1-, 3-, and 5-year survival outcomes (overall survival [OS] and/or DFS) were comparable in both groups.

CONCLUSIONS:

Compared with OMLR, LMLR has short-term clinical advantages, including reduced blood loss, lower postsurgical morbidity, and shorter hospital stay in HCC, despite its longer operative time. Long-term oncological outcomes were comparable in both groups.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Carcinoma Hepatocelular / Hepatectomia / Fígado / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Laparoscopia / Carcinoma Hepatocelular / Hepatectomia / Fígado / Neoplasias Hepáticas Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Limite: Humans Idioma: En Revista: BMC Cancer Assunto da revista: NEOPLASIAS Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China