Clinical Study Of Laparoscopic Hepatectomy For Liver Cancer Compare With Open Hepatectomy

Objective To compare perioperative and long-term outcomes of laparoscopic and open hepatectomy in the management of liver cancer and evaluate the feasibility and safety of liver resection for malignant lesions under laparoscope. Methods Form August 1998 to May 2006,31 laparoscopic liver resections for malignant liver tumors were enrolled for this study.The intraoperative hazard ,recovery and the long-term outcomes of these patients were compared with 31 conventional liver resections in a pair analysis.The controls, matched for age,sex,tumor size and location,and the presence or absence of cirrhosis, were selected from a computer database of more than 500 liver resections performed at the same period as laparoscopic group.Results 30 cases in laparoscopic group were performed successfully while a conversion to open surgery was required in 1 case because of intra-operative hemorrhage .Oral intake and hospital stay in laparoscopic group were 1.5(1-3)d and 7.5(5-15)d respectively,which was significantly shorter than those in open group(p<0.01).And the mean operative time and blood loss were 502.9 (50-2000) ml and 140.1 (60—380) min respectively ,which was shorter than those in open group but has no significantly difference.There were no operative complications and no deaths in laparoscopic group.The mean follow-up time of the two groups were 29.77 (10—103)和 29.9(8-74) months, respectively.The mean and median survival time of laparoscopic group were 59.34and 70months, respectively.And the l-,3-,5- survival rate in each group were 96.55%, 60.47%, 50.40% and 96.77%, 68.36%, 50.64%, respectively.By log -rank test,these two survival curves were not significantly different(p=0.8535).Conclusion Our study shows that laparoscopic hepatectomy for liver cancer in selected patients is a safe and effective procedure with a very good short-term results, and the long-term outcomes are similar to those for laparotomy.