Laparoscopic versus open surgery in the treatment of hepatic hemangioma A meta-analysis

Background: The aim of this study was to systematically evaluate and compare the effectiveness and safety of laparoscopic versus open resection (LR vs OR) in the treatment of hepatic hemangioma. Methods: We searched PubMed, the Cochrane Library, Web of Science, Medline, EMBASE, and the Chinese Biomedicine Database from January 2000 to April 2020 for studies comparing the outcomes of laparoscopic versus open surgery in hepatic hemangioma treatment. Results: Based on the preset criteria, 12 randomized clinical trials (RCTs) and 12 observational clinical studies (OCSs) were selected for analysis. Our results showed that laparoscopic surgery was more effective than open surgery in terms of reducing operation time, intraoperative blood loss, postoperative exhaust time, postoperative complications, postoperative bile leak, postoperative intra-abdominal infection, postoperative alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values, postoperative visual analog scale (VAS) scores, and hospitalize length. No significant differences were found between the 2 groups in hepatectomy time, hospitalized cost, intra-abdominal hemorrhage, and the postoperative recurrence of hemangioma. Conclusion: While similar therapeutic effect was achieved by the compared herein surgical methods, the findings of our analysis revealed that laparoscopic surgery is superior over open surgery in terms of less trauma, faster recovery, less postoperative pain, shorter hospitalize length, and reduced postoperative complications. Therefore, laparoscopic resection of hepatic hemangioma is a safe, effective, and feasible surgical method that is worth considering in clinical applications.