Minimally invasive vs traditional liver resection in managing small hepatocellular carcinoma

Abstract

Background Laparoscopic liver resection (LLR) has been progressively developed along the past two decades. Surgical technique and equipment have been evolved to overcome technical limitations, making LLR safe and feasible. Surgeons develop skills in a stepwise approach, beginning with low complexity operations for benign diseases and reaching high-complexity surgeries for malignant cases and living donor organ harvesting. Patients and methods In this prospective randomized study, a comparison between laparoscopic and open resection was done to compare short-term results regarding intraoperative details, postoperative management, and complications. This study was conducted on 30 patients with hepatocellular carcinoma (HCC): 15 (50%) patients were treated by LLR (group A), whereas the other 15 (50%) patients were treated by open liver resection (group B). Results Regarding the demographic data, the presence of past history of medical condition, and the preoperative laboratory results, no statistically significant difference was found. The mean operative time has a statistically significant difference between the two groups, with decreased operative time in the laparoscopic group (P Conclusion LLR is a safe and feasible treatment option for HCC in cirrhotic patient needing minor resection at laparoscopic liver segments II, III, IVa, V, and VI. LLR for HCC has superior short-term and comparable oncological outcomes to open liver resection. LLR should be performed for carefully selected patients and by an expert surgical team.