Meta-analysis of efficacy of laparoscopic hepatectomy versus open hepatectomy for hepatocarcinoma.

Abstract

The aim of this study was to summarize the current evidence to evaluate the effects of laparoscopic hepatectomy (LH) and open hepatectomy (OH) in the treatment of hepatocarcinoma. A comprehensive literature search was performed using PubMed, Embase, and Google Scholar to identify all relevant studies. After we screened further, 22 published studies were included in this meta-analysis. We pooled the odds ratios (ORs), standardized mean difference (SMD) and conducted heterogeneity, quality assessment. The outcomes of treatment effects included surgical blood loss, surgical time, postoperative complications, perioperative mortality, 3-year survival rate, and 5-year survival rate. Comparing OH for liver cancer patients, the pooled SMD of surgical blood loss was -0.65 (95% confidential index [confidence interval (CI)] = [-0.80, -0.50]), the pooled SMD of surgical time was -0.12 (95% CI = [-0.25, -0.00]), the pooled OR of postoperative complications was 0.48 (95% CI = [0.38, 0.62]), the pooled OR of perioperative mortality was 0.34 (95% CI = [0.14, 0.84]), the pooled OR of 3-year survival rate was 1.03 (95% CI = [0.76, 1.39]), and the pooled OR of 5-year survival rate was 0.99 (95% CI = [0.75, 1.30]). LH was found to significantly decrease patients' blood loss. LH slightly decreases surgical time. In addition, LH appears not to affect 3- and 5-year survival rate, but it offers less postoperative complications and perioperative mortality.