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Pure Laparoscopic Hepatectomy Versus Open Hepatectomy For Hepatocellular Carcinoma In 110 Patients With Liver Cirrhosis - A Propensity Analysis In A Single Center.
Tan To Cheung*, Chung Mau Lo
Queen Mary Hospital, the University of Hong Kong, Hong Kong, Hong Kong

OBJECTIVE(S):
Laparoscopic liver resection has been gaining popularity but it has not been widely accepted in many major centers because previous published data involves small case numbers. The worries of bleeding and survival outcome has hindered the development of this method particularly in patients with cirrhosis.
METHODS:
1358 patients underwent hepatectomy for HCC from 2006 to 2015. To avoid selection bias, propensity score matching in a ratio of 1:3 with open hepatectomy was performed.
RESULTS:
110 patients had pure laparoscopic liver resection. 330 patients were matched in the open liver resection group. Pure laparoscopic group has less median blood loss (150ml vs 400ml, P<0.01), shorter operation time (285minutes vs 255minutes, P<0.001) and shorter hospital stay (4days vs 7 days, p<0.001).
In pure laparoscopic group the 1 year, 3 year and 5 year overall survival vs open group was 98.9%, 89.8%, 83.7% vs 94%, 79.3% and 67.4% respectively P=0.033. The disease free survival was 87.7%, 65.8%, 52.5% vs 75.2% 56.3% and 47.9% respectively.
CONCLUSIONS:
Laparoscopic liver resection can be carried out safely with favorable short terms and long terms outcome even in patients with hepatectomy and cirrhosis in high volume center for liver cancer treatment.


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