Laparoscopic versus open liver resection: a meta-analysis of long-term outcome.
Bottom Line: Subset analyses of hepatocellular carcinoma (HCC) and colorectal metastases (CRM) were performed.There was no difference in the 1-, 3-, and 5-year survival for HCC or in the 1-year survival for CRM, however, a survival advantage was found for CRM at 3 years (LHep 80% versus OHep 67.4%, P = 0.036).Laparoscopic surgery should be considered an acceptable alternative for the treatment of malignant liver tumours.
Affiliation: Department of Surgery, Jersey Shore University Medical Center; Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.Show MeSH
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Mentions: All 15 studies were analysed for long-term survival for all malignancies. Using available data from 14 studies, LHep was shown to have a 92.6% survival at 1 year, whereas OHep was comparable at 90.51% (OR 0.71, 95% CI 0.42 to 1.20, P = 0.202) (Fig. 2). Fourteen studies had available data for 3-year survival with a 76.5% survival for LHep and 71.6% survival for OHep (OR 0.76, 95% CI 0.56 to 1.03, P = 0.076) (Fig. 3). Five-year survival was reported in 10 studies. At 5 years, the meta-analysis found a 61.7% survival for LHep and 56.4% for OHep (OR 0.80, 95% CI 0.59 to 1.10, P = 0.173) (Fig. 4). No significant difference was found in the 1-, 3-or 5-year survival for all malignant tumours after LHep versus OHep. There was no evidence of publication bias amongst the studies based on the funnel plot and the weighted linear regression approach [1-year: t = 1.170, degrees of freedom (d.f.) = 12, P = 0.265; 3-years t = −0.405, d.f. = 12, P = 0.693; 5-years t = −1.49, d.f. = 8, P = 0.175; funnel plots not shown).
Affiliation: Department of Surgery, Jersey Shore University Medical Center; Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.