Comparative clinical study of laparoscopic versus open liver resection in elderly patients with hepatocellular carcinoma

Abstract

Objective To evaluate the feasibility and efficacy of laparoscopic liver resection (LLR) in elderly patients with hepatocellular carcinoma (HCC). Methods Twenty-nine elderly patients undergoing laparoscopic liver resection (LLR) and 58 elderly patients receiving open liver resection (OLR) for HCC were included from January 2013 to December 2015 in our department of Fujian Medical University.Two groups were 1∶2 matched for gender, tumor numbers, and operative procedure.Besides, general clinical data, intraoperative data, postoperative recovery, and postoperative survival were compared. Results The postoperative hospital stay was shorter in the LLR group[(9.1±3.8) days]than in the OLR group[(11.8±5.1) days](t=-2.66, P<0.05). The incidence of portal triad clamping was lower in the LLR group than in the OLR group (34.5% vs.60.3%, χ2=5.18, P<0.05). The removal time of abdominal drainage tube was earlier in the LLR group (4.18 ± 1.94)days than in the OLR group (5.4±2.1)days (t=-2.48, P<0.05). The overall survival (OS) showed no difference (37.08 months vs.38.72 months, t=0.72, P=0.789). The disease-free survival (DFS) showed no difference (29.00 months vs.27.49 months, t=0.53, P=0.467). Conclusions LLR in elderly patients with HCC can achieve the same long-term outcome as the conventional open hepatectomy, and LLR has better short-term outcomes with obvious advantages of minimal invasion. Key words: Laparoscopes; Hepatectomy; Hepatocellular carcinoma