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Meta-Analysis
. 2014 Feb;16(2):109-18.
doi: 10.1111/hpb.12117. Epub 2013 May 15.

Laparoscopic versus open liver resection: a meta-analysis of long-term outcome

Kevin Ryan Parks  1 , Yen-Hong Kuo, John Mihran Davis, Brittany O' Brien, Ellen J Hagopian
Affiliations
Meta-Analysis

Laparoscopic versus open liver resection: a meta-analysis of long-term outcome

Kevin Ryan Parks et al. HPB (Oxford). 2014 Feb.

Abstract

Background: Laparoscopic liver resection is growing in popularity, but the long-term outcome of patients undergoing laparoscopic liver resection for malignancy has not been established. This paper is a meta-analysis and compares the long-term survival of patients undergoing laparoscopic (LHep) versus open (OHep) liver resection for the treatment of malignant liver tumours.

Methods: A PubMed database search identified comparative human studies analysing LHep versus OHep for malignant tumours. Clinical and survival parameters were extracted. The search was last conducted on 18 March 2012.

Results: In total, 1002 patients in 15 studies were included (446 LHep and 556 OHep). A meta-analysis of overall survival showed no difference [1-year: odds ratio (OR) 0.71, 95% confidence interval (CI) 0.42 to 1.20, P = 0.202; 3-years: OR 0.76, 95% CI 0.56 to 1.03, P = 0.076; 5-years: OR 0.8, 95% CI 0.59 to 1.10, P = 0.173]. 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).

Conclusions: Laparoscopic surgery should be considered an acceptable alternative for the treatment of malignant liver tumours.

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Figures

Figure 1
Figure 1
Selection of included studies for meta-analysis
Figure 2
Figure 2
All-cancers: risk of death, 1-year
Figure 3
Figure 3
All-cancers: risk of Death, 3-year
Figure 4
Figure 4
All-cancers: risk of death, 5-year
Figure 5
Figure 5
Hepatocellular carcinoma (HCC): risk of death, 1-year
Figure 6
Figure 6
Hepatocellular carcinoma (HCC): risk of death, 3-year
Figure 7
Figure 7
Hepatocellular carcinoma (HCC): risk of death, 5-year
Figure 8
Figure 8
Colorectal metastases (CRM): risk of death, 1-year
Figure 9
Figure 9
Colorectal metastases (CRM): risk of death, 3-year
See this image and copyright information in PMC

References

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