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

IF 1.7 4区医学 Q2 SURGERY Minimally Invasive Therapy & Allied Technologies Pub Date : 2024-04-18 DOI:10.1080/13645706.2024.2334762

Zha Peng, Zhuang-Rong Zhu, Cheng-Yi He, Hai Huang

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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% CI:0.37-0.66, p < 0.00001; OR: 0.54, 95% CI:0.36 - 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.

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一项荟萃分析：腹腔镜与开腹肝切除术治疗大肝细胞癌的比较。

背景：腹腔镜肝切除术（LLR）治疗巨大肝细胞癌（HCC）的适应症存在争议。在这项研究中，我们比较了腹腔镜肝切除术和开腹肝切除术（OLR）治疗巨大肝细胞癌的短期和长期疗效：我们在 PubMed、Cochrane Library 和 EMBASE 中检索了符合条件的关于大块 HCC 的 LLR 与 OLR 的文章，并进行了荟萃分析：结果：共纳入8篇文献，涉及1338名患者。结果：共收录了 8 篇文献，涉及 1,338 例患者，其中 495 例接受了 LLR，843 例接受了 OLR。腹腔镜组的手术时间较长（MD：22.23，95% CI：4.14-40.33，P = 0.02），但术后住院时间明显较短（MD：-4.88，CI：-5.55--4.23，P = 0.003）。腹腔镜组患者的术中失血量、术中输血率、切除边缘大小、R0切除率、三年总生存率（OS）和三年无病生存率（DFS）均无明显差异：结论：大型 HCC 的 LLR 安全可行。结论：LLR 治疗大型 HCC 安全可行，这种手术策略不会影响患者的长期预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Minimally Invasive Therapy & Allied Technologies 医学-外科

CiteScore

3.80

自引率

5.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Minimally Invasive Therapy and Allied Technologies (MITAT) is an international forum for endoscopic surgeons, interventional radiologists and industrial instrument manufacturers. It is the official journal of the Society for Medical Innovation and Technology (SMIT) whose membership includes representatives from a broad spectrum of medical specialities, instrument manufacturing and research. The journal brings the latest developments and innovations in minimally invasive therapy to its readers. What makes Minimally Invasive Therapy and Allied Technologies unique is that we publish one or two special issues each year, which are devoted to a specific theme. Key topics covered by the journal include: interventional radiology, endoscopic surgery, imaging technology, manipulators and robotics for surgery and education and training for MIS.