Comparison Of The Efficacy Of Laparoscopic Hepatectomy And Open Hepatectomy In The Treatment Of Hepatocellular Carcinoma—Meta Analysis

Objective:To evaluate surgical safety and effectiveness of laparoscopic hepatectomy（LH）in short-and long-term outcomes compared to open hepatectomy（OH）in patients operated for hepatocellular carcinoma（HCC）.Methods:An electronic search until August 2017 was conducted to identify comparative studies evaluating laparoscopic versus open liver resection for HCC.Results:A total of 5889 patients（2421 underwent LH,and 3468 with OH）were included in our meta-a—lysis from 47 studies.LHs were associated favorable outcomes in operative blood loss（MD:-147.27,95%CI:-217.00,-77.55）,blood transfusion requirement（OR:0.51,95%CI:0.40 to 0.65）,pathologic resection margins（MD:0.07 95%CI:0.02,0.12,P value=0.01）,R₀ resection rate（OR:1.34 95%CI:0.98,1.84,P value=0.07）and length of hospital stay（MD:-5.13,95%CI:-6.23,-4.03）.There were no differences between the groups in overall survival at 1,3 and 5 years（（1-OS,3-OS,5-OS））（OR:1.41,95%CI:1.00,1.98;OR:1.12,95%CI:0.93,1.36;OR:1.18,95%CI:0.94,1.46）,in disease-free survival at 1,3 and 5 years（1-DFS,3-DFS,5-DFS）（OR:1.19,95%CI:0.94,1.51;OR:1.07,95%CI:0.86,1.33;OR:1.13,95%CI:0.92,1.40）and in recurrence（OR:0.90,95%CI:0.74,1.08）.Conclusion:Compared to OH,LH is superior to reduce the intraoperative blood loss and blood transfusion,to expand the pathologic resection margins and increase R₀resection rate and to shorter length of hospital stay.LH has similar OS,DFS and the recurrence with OH.