Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis

Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis

Aim:  Laparoscopic hepatectomy has become a common method for treatment of hepatocellular carcinoma (HCC) nowadays, but the oncologic risks of laparoscopic liver resection for HCC are still under investigation. We performed a meta‐analysis to quantitatively compare surgical and oncologic outcomes of...

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Veröffentlicht in:Hepatology research 2012-01, Vol.42 (1), p.51-59
Hauptverfasser: Li, Ning, Wu, Yong-Rong, Wu, Bin, Lu, Min-Qiang
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hepatectomy
hepatocellular carcinoma
meta-analysis
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creator Li, Ning
Wu, Yong-Rong
Wu, Bin
Lu, Min-Qiang
description Aim:  Laparoscopic hepatectomy has become a common method for treatment of hepatocellular carcinoma (HCC) nowadays, but the oncologic risks of laparoscopic liver resection for HCC are still under investigation. We performed a meta‐analysis to quantitatively compare surgical and oncologic outcomes of patients with HCC undergoing laparoscopic versus open hepatectomy. Methods:  Systematic review and meta‐analysis of studies comparing laparoscopic with open liver resection for HCC. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5. Results:  Ten studies comprising 627 patients were eligible for inclusion. The overall rate of conversion to open surgery was 6.6%. The laparoscopic group had significantly less blood loss by 223.17 mL (95% confidence interval [CI]: −331.81, −114.54; P 
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We performed a meta‐analysis to quantitatively compare surgical and oncologic outcomes of patients with HCC undergoing laparoscopic versus open hepatectomy. Methods:  Systematic review and meta‐analysis of studies comparing laparoscopic with open liver resection for HCC. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5. Results:  Ten studies comprising 627 patients were eligible for inclusion. The overall rate of conversion to open surgery was 6.6%. The laparoscopic group had significantly less blood loss by 223.17 mL (95% confidence interval [CI]: −331.81, −114.54; P &lt; 0.0001), fewer need for transfusions (odds ratio [OR]: 0.42, 95% CI: 0.22, .079; P = 0.007), shorter hospital stay by 5.05 days (95% CI: −7.84, −2.25; P = 0.0004) and fewer postoperative complications (OR: 0.50; 95% CI: 0.32, 0.77; P = 0.002). No significant differences were found concerning surgery margin (weighted mean differences [WMD], 0.55; 95% CI: −0.71, 1.80; P = 0.39), resection margin positive rate (OR, 0.63; 95% CI: 0.25, 1.54; P = 0.31) and tumor recurrence (OR, 0.79; 95% CI: 0.49, 1.27; P = 0.33). In the 244 patients that underwent laparoscopic hepatectomy of all 10 studies included, no patients developed tumor recurrence at the site of resection margin, peritoneal dissemination or trocar‐site metastases. Conclusions:  On currently available evidence, laparoscopic resection appears not to affect oncologic outcomes and increase tumor recurrence. It also offers less blood loss, decreased rate of intraoperative transfusion and shorter lengths of hospital stay. Laparoscopic resection is a safe and feasible choice for selected patients with HCC.</description><identifier>ISSN: 1386-6346</identifier><identifier>EISSN: 1872-034X</identifier><identifier>DOI: 10.1111/j.1872-034X.2011.00890.x</identifier><identifier>PMID: 21988222</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>hepatectomy ; hepatocellular carcinoma ; meta-analysis</subject><ispartof>Hepatology research, 2012-01, Vol.42 (1), p.51-59</ispartof><rights>2011 The Japan Society of Hepatology</rights><rights>2011 The Japan Society of Hepatology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5250-e71a4ddb8db67f58d396a2fe807b4cfe982d5261454818802e68f4fec330cf443</citedby><cites>FETCH-LOGICAL-c5250-e71a4ddb8db67f58d396a2fe807b4cfe982d5261454818802e68f4fec330cf443</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1872-034X.2011.00890.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1872-034X.2011.00890.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21988222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Ning</creatorcontrib><creatorcontrib>Wu, Yong-Rong</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Lu, Min-Qiang</creatorcontrib><title>Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis</title><title>Hepatology research</title><addtitle>Hepatol Res</addtitle><description>Aim:  Laparoscopic hepatectomy has become a common method for treatment of hepatocellular carcinoma (HCC) nowadays, but the oncologic risks of laparoscopic liver resection for HCC are still under investigation. We performed a meta‐analysis to quantitatively compare surgical and oncologic outcomes of patients with HCC undergoing laparoscopic versus open hepatectomy. Methods:  Systematic review and meta‐analysis of studies comparing laparoscopic with open liver resection for HCC. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5. Results:  Ten studies comprising 627 patients were eligible for inclusion. The overall rate of conversion to open surgery was 6.6%. The laparoscopic group had significantly less blood loss by 223.17 mL (95% confidence interval [CI]: −331.81, −114.54; P &lt; 0.0001), fewer need for transfusions (odds ratio [OR]: 0.42, 95% CI: 0.22, .079; P = 0.007), shorter hospital stay by 5.05 days (95% CI: −7.84, −2.25; P = 0.0004) and fewer postoperative complications (OR: 0.50; 95% CI: 0.32, 0.77; P = 0.002). No significant differences were found concerning surgery margin (weighted mean differences [WMD], 0.55; 95% CI: −0.71, 1.80; P = 0.39), resection margin positive rate (OR, 0.63; 95% CI: 0.25, 1.54; P = 0.31) and tumor recurrence (OR, 0.79; 95% CI: 0.49, 1.27; P = 0.33). In the 244 patients that underwent laparoscopic hepatectomy of all 10 studies included, no patients developed tumor recurrence at the site of resection margin, peritoneal dissemination or trocar‐site metastases. Conclusions:  On currently available evidence, laparoscopic resection appears not to affect oncologic outcomes and increase tumor recurrence. It also offers less blood loss, decreased rate of intraoperative transfusion and shorter lengths of hospital stay. Laparoscopic resection is a safe and feasible choice for selected patients with HCC.</description><subject>hepatectomy</subject><subject>hepatocellular carcinoma</subject><subject>meta-analysis</subject><issn>1386-6346</issn><issn>1872-034X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqNkEtv1DAURi0Eog_4C8g7Vgl-JXGQWFRVaaupABUQiI3lca6LBycOdkJndvx0HKbMGm_sq_uda_sghCkpaV6vNiWVDSsIF19LRigtCZEtKbeP0PGh8TifuayLmov6CJ2ktCGENoSJp-iI0VZKxtgx-v1xjnfOaI_10OEwmOBDrnGYJxN6SNgG78O9G-6w16OOIZkw5v4viGlOOIwwYO9yhSMkMJMLQ0Yi_g6jnoIB72evIzY6GjeEXr_GZ7iHSRd60H6XXHqGnljtEzx_2E_R57cXn86vipv3l9fnZzeFqVhFCmioFl23lt26bmwlO97WmlmQpFkLY6GVrKtYTUUlJJWSMKilFRYM58RYIfgpermfO8bwc4Y0qd6l5X16gDAn1VJGScuaJSn3SZN_myJYNUbX67hTlKhFv9qoxbJaLKtFv_qrX20z-uLhknndQ3cA__nOgTf7wL3zsPvvwerq4sNtPmW-2PMuTbA98Dr-UHXDm0p9eXepSPVttbpdMdXyP40Tpj4</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Li, Ning</creator><creator>Wu, Yong-Rong</creator><creator>Wu, Bin</creator><creator>Lu, Min-Qiang</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201201</creationdate><title>Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis</title><author>Li, Ning ; Wu, Yong-Rong ; Wu, Bin ; Lu, Min-Qiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5250-e71a4ddb8db67f58d396a2fe807b4cfe982d5261454818802e68f4fec330cf443</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>hepatectomy</topic><topic>hepatocellular carcinoma</topic><topic>meta-analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Ning</creatorcontrib><creatorcontrib>Wu, Yong-Rong</creatorcontrib><creatorcontrib>Wu, Bin</creatorcontrib><creatorcontrib>Lu, Min-Qiang</creatorcontrib><collection>Istex</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Ning</au><au>Wu, Yong-Rong</au><au>Wu, Bin</au><au>Lu, Min-Qiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis</atitle><jtitle>Hepatology research</jtitle><addtitle>Hepatol Res</addtitle><date>2012-01</date><risdate>2012</risdate><volume>42</volume><issue>1</issue><spage>51</spage><epage>59</epage><pages>51-59</pages><issn>1386-6346</issn><eissn>1872-034X</eissn><abstract>Aim:  Laparoscopic hepatectomy has become a common method for treatment of hepatocellular carcinoma (HCC) nowadays, but the oncologic risks of laparoscopic liver resection for HCC are still under investigation. We performed a meta‐analysis to quantitatively compare surgical and oncologic outcomes of patients with HCC undergoing laparoscopic versus open hepatectomy. Methods:  Systematic review and meta‐analysis of studies comparing laparoscopic with open liver resection for HCC. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5. Results:  Ten studies comprising 627 patients were eligible for inclusion. The overall rate of conversion to open surgery was 6.6%. The laparoscopic group had significantly less blood loss by 223.17 mL (95% confidence interval [CI]: −331.81, −114.54; P &lt; 0.0001), fewer need for transfusions (odds ratio [OR]: 0.42, 95% CI: 0.22, .079; P = 0.007), shorter hospital stay by 5.05 days (95% CI: −7.84, −2.25; P = 0.0004) and fewer postoperative complications (OR: 0.50; 95% CI: 0.32, 0.77; P = 0.002). No significant differences were found concerning surgery margin (weighted mean differences [WMD], 0.55; 95% CI: −0.71, 1.80; P = 0.39), resection margin positive rate (OR, 0.63; 95% CI: 0.25, 1.54; P = 0.31) and tumor recurrence (OR, 0.79; 95% CI: 0.49, 1.27; P = 0.33). In the 244 patients that underwent laparoscopic hepatectomy of all 10 studies included, no patients developed tumor recurrence at the site of resection margin, peritoneal dissemination or trocar‐site metastases. Conclusions:  On currently available evidence, laparoscopic resection appears not to affect oncologic outcomes and increase tumor recurrence. It also offers less blood loss, decreased rate of intraoperative transfusion and shorter lengths of hospital stay. Laparoscopic resection is a safe and feasible choice for selected patients with HCC.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21988222</pmid><doi>10.1111/j.1872-034X.2011.00890.x</doi><tpages>9</tpages></addata></record>
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subjects hepatectomy
hepatocellular carcinoma
meta-analysis
title Surgical and oncologic outcomes following laparoscopic versus open liver resection for hepatocellular carcinoma: A meta-analysis
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