Comparison of Clinical Efficacy and Complications Between Laparoscopic Partial and Open Partial Hepatectomy for Liver Carcinoma: A Meta-Analysis

J Laparoendosc Adv Surg Tech A. 2019 Feb;29(2):225-232. doi: 10.1089/lap.2018.0346. Epub 2019 Jan 17.

Abstract

Objective: To contrast the clinical effects and complications for the treatment of liver carcinoma in laparoscopic partial hepatectomy (LPH) and open partial hepatectomy (OPH).

Methods: The multiple databases were adopted to search relevant studies, and the articles eventually satisfying the inclusion criteria were included. All the meta-analyses were conducted with the Review Manager 5.3, and to estimate the quality of each article risk of bias table was performed.

Results: In the end, 17 studies including 3897 patients were involved, which eventually satisfied the eligibility criteria. The number of samples in LPH group and OPH group were 1723 and 2174, respectively. The results of heterogeneity test suggested that recurrence rate (odds ratio [OR] = -20.11, 95% confidence interval, CI [-35.93 to -4.29], P = .01; P for heterogeneity <.00001, I2 = 100%), hospital days (mean difference (MD) = -2.21, 95% CI [-2.53 to -1.88], P < .000001; P for heterogeneity = .41, I2 = 58%), and blood loss (MD = -68.09, 95% CI [-85.07 to -51.11], P < .00001; P for heterogeneity = .13, I2 = 37%) were significantly different, whereas operating time (MD = 4.00, 95% CI [-17.50 to 25.49], P = .72; P for heterogeneity <.00001, I2 = 99%) and complication events (OR = 0.68, 95% CI [0.46 to 1.01], P = .05; P for heterogeneity = .34, I2 = 11%) between LPH and OPH were insignificantly different.

Conclusion: This study demonstrated that clinical efficacy of OPH was better than that of LPH to some extent, but LPH was a quicker recovery and less harmful therapy.

Keywords: laparoscopic partial hepatectomy (LPH); liver carcinoma; open partial hepatectomy (OPH).

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review

MeSH terms

  • Blood Loss, Surgical
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Neoplasm Recurrence, Local*
  • Operative Time
  • Postoperative Complications / etiology
  • Treatment Outcome