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Long-Term Survival Analysis of Pure Laparoscopic Versus Open Hepatectomy for Hepatocellular Carcinoma in Patients With Cirrhosis: A Single-Center Experience

Cheung, Tan To MBBS, FRCS*; Poon, Ronnie T. P. MS, PhD, FRCS, FACS*,†; Yuen, Wai Key MBBS, FRCS, FACS*; Chok, Kenneth S. H. MBBS, FRCS*; Jenkins, Caroline R. MBBS; Chan, See Ching MS, PhD, FRCS, FACS*,†; Fan, Sheung Tat MS, MD, PhD, DSc, FRCS, FACS*,†; Lo, Chung Mau MS, FRCS, FACS*,†

doi: 10.1097/SLA.0b013e31827b947a
Original Articles

Introduction: Laparoscopic liver resection has been reported as a safe and effective approach to the management of liver cancer. However, studies of long-term outcomes regarding tumor recurrence and patient survival in comparison with the conventional open approach are limited. The aim of this study was to analyze the survival outcome of laparoscopic liver resection versus open liver resection.

Patients and Methods: Between October 2002 and September 2009, 32 patients underwent pure laparoscopic liver resection for hepatocellular carcinoma (HCC). Case-matched control patients (n = 64) who received open liver resection for HCC were included for comparison. Patients were matched in terms of cancer stage, tumor size, location of tumor, and magnitude of resection. Immediate operation outcomes, operation morbidity, disease-free survival, and overall survival were compared between groups.

Results: With the laparoscopic group compared with the open resection group, operation time was 232.5 minutes versus 204.5 minutes (P = 0.938), blood loss was 150 mL versus 300 mL (P = 0.001), hospital stay was 4 days versus 7 days (P < 0.0001), postoperative complication was 2 (6.3%) versus 12 (18.8%) (P = 0.184), disease-free survival was 78.5 months versus 29 months (P = 0.086), and overall survival was 92 months versus 71 months (P = 0.142). The disease-free survival for stage II HCC was 22.1 months versus 12.4 months (P = 0.075).

Conclusions: Laparoscopic liver resection for HCC is associated with less blood loss, shorter hospital stay, and fewer postoperative complications in selected patients with no compromise in survival.

There are inadequate data on laparoscopic liver resection for hepatocellular carcinoma in patients with cirrhosis. In this study, the long-term results of 32 patients treated with pure laparoscopic hepatectomy and those of 64 case-matched control patients treated with open hepatectomy were compared. The median overall survival was 92 months versus 71 months (P = 0.142).

*Department of Surgery, The University of Hong Kong, Hong Kong, China

State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China

Department of Anaesthesiology, The University of Hong Kong, Hong Kong, China.

Reprints: Tan To Cheung, MBBS, Department of Surgery, The University of Hong Kong, 102 Pokfulam Rd, Hong Kong, China. E-mail:

Disclosure: The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.