Meta-analysis of efficacy of laparoscopic hepatectomy versus open hepatectomy for hepatocarcinoma

Objective: The aim of this study was to summarize the current evidence to evaluate the effects of laparoscopic hepatectomy (LH) and open hepatectomy (OH) in the treatment of hepatocarcinoma. Methods: A comprehensive literature search was performed using PubMed, Embase, and Google Scholar to identify all relevant studies. After we screened further, 22 published studies were included in this meta-analysis. We pooled the odds ratios (ORs), standardized mean difference (SMD) and conducted heterogeneity, quality assessment. Results: The outcomes of treatment effects included surgical blood loss, surgical time, postoperative complications, perioperative mortality, 3-year survival rate, and 5-year survival rate. Comparing OH for liver cancer patients, the pooled SMD of surgical blood loss was -0.65 (95% confidential index [confidence interval (CI)] = [-0.80, -0.50]), the pooled SMD of surgical time was -0.12 (95% CI = [-0.25, -0.00]), the pooled OR of postoperative complications was 0.48 (95% CI = [0.38, 0.62]), the pooled OR of perioperative mortality was 0.34 (95% CI = [0.14, 0.84]), the pooled OR of 3-year survival rate was 1.03 (95% CI = [0.76, 1.39]), and the pooled OR of 5-year survival rate was 0.99 (95% CI = [0.75, 1.30]). Conclusion: LH was found to significantly decrease patients' blood loss. LH slightly decreases surgical time. In addition, LH appears not to affect 3- and 5-year survival rate, but it offers less postoperative complications and perioperative mortality.