Jie Chen1, Tao Bai1, Yu Zhang1, Zhi-Bo Xie1, Xiao-Bo Wang1, Fei-Xiang Wu1, Le-Qun Li1. 1. Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical UniversityNanning 530021, PR China; Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research CenterNanning 530021, PR China.
Abstract
BACKGROUND: Compared with open hepatectomy (OH), laparoscopic hepatectomy (LH) had better short-term outcomes in normal hepatocellular carcinoma (HCC) patients. Since liver cirrhosis is the major risk of HCC, serve postoperative complications can be observed after LH in HCC patients with cirrhosis. We conducted this systematic review to analysis the safety and the efficiency of LH in HCC patients with liver cirrhosis. METHODS: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through March 2015. Risk ratios (RRs), weigh mean difference (WMD) and 95% confidence intervals (CIs) were calculated. RESULTS: The analysis included 7 retrospective trials, altogether involving 828 patients. Patients in LH group had wider tumor margin (WMD = 0.12, 95% CI 0.04 to 0.21, P = 0.003), less blood loss (WMD = -157.25, 95% CI -295.05 to -19.45, P = 0.03), less blood transfusion (RR = 0.41, 95% CI 0.22 to 0.74, P = 0.004), less postoperative mobility (RR = 0.48, 95% CI 0.35 to 0.66, P<0.001) and less hospital stay (WMD = -4.11, 95% CI -6.23 to -1.98, P<0.001). Overall survival (OS) and disease free survival (DFS) were similar between 2 groups, except LH had a better 5-year survival rate (RR = 1.28, 95% CI 1.01 to 1.62, P = 0.04). CONCLUSION: In HCC patients with liver cirrhosis, LH have short-term outcomes advantages of tumor margin, blood loss, blood transfusion, postoperative mobility, and hospital stay. OS and DFS were similar between LH and OH. LH is safe in HCC patients with liver cirrhosis.
BACKGROUND: Compared with open hepatectomy (OH), laparoscopic hepatectomy (LH) had better short-term outcomes in normal hepatocellular carcinoma (HCC) patients. Since liver cirrhosis is the major risk of HCC, serve postoperative complications can be observed after LH in HCCpatients with cirrhosis. We conducted this systematic review to analysis the safety and the efficiency of LH in HCCpatients with liver cirrhosis. METHODS: MEDLINE, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure database, and clinical trial registries were searched through March 2015. Risk ratios (RRs), weigh mean difference (WMD) and 95% confidence intervals (CIs) were calculated. RESULTS: The analysis included 7 retrospective trials, altogether involving 828 patients. Patients in LH group had wider tumor margin (WMD = 0.12, 95% CI 0.04 to 0.21, P = 0.003), less blood loss (WMD = -157.25, 95% CI -295.05 to -19.45, P = 0.03), less blood transfusion (RR = 0.41, 95% CI 0.22 to 0.74, P = 0.004), less postoperative mobility (RR = 0.48, 95% CI 0.35 to 0.66, P<0.001) and less hospital stay (WMD = -4.11, 95% CI -6.23 to -1.98, P<0.001). Overall survival (OS) and disease free survival (DFS) were similar between 2 groups, except LH had a better 5-year survival rate (RR = 1.28, 95% CI 1.01 to 1.62, P = 0.04). CONCLUSION: In HCCpatients with liver cirrhosis, LH have short-term outcomes advantages of tumor margin, blood loss, blood transfusion, postoperative mobility, and hospital stay. OS and DFS were similar between LH and OH. LH is safe in HCCpatients with liver cirrhosis.
Entities:
Keywords:
Hepatocellular carcinoma; laparoscopic; meta-analysis; open hepatectomy; surgery
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