Clinical effect of laparoscopic versus open liver resection in treatment of patients with hepatocellular carcinoma complicated by liver cirrhosis

Objective To investigate the clinical effect of laparoscopic liver resection( LLR) versus open liver resection( OLR) in the treatment of patients with hepatocellular carcinoma( HCC) complicated by liver cirrhosis. Methods A total of 136 patients who were diagnosed with HCC complicated by liver cirrhosis in Linxia Municipal People's Hospital from January 2006 to December 2007 were enrolled and underwent LLR( LLR group,64 patients) or OLR( OLR group,72 patients). The short-term outcome,pathological factors,and long-term outcome were compared between the two groups. The t-test was used for comparison of continuous data between groups,the chi-square test was used for comparison of categorical data between groups,and the log-rank test was used for comparison of survival functions.Results There were significant differences between the LLR group and the OLR group in time of operation(( 86. 43 ± 23. 55) min vs( 62. 31 ± 19. 61) min,t = 8. 539,P < 0. 001) and length of postoperative hospital stay(( 7. 22 ± 3. 45) d vs( 12. 27 ± 5. 31) d,t =2. 764,P = 0. 024),while there were no significant differences in intraoperative blood loss,time of hepatic portal occlusion,and overall fatality rate( all P > 0. 05). There were also no significant differences in number of tumors,presence or absence of liver cirrhosis,microvascular invasion,resection margin,and maximum tumor diameter between the two groups( all P > 0. 05). As for long-term outcome,the 1-,3-,and 5-year disease-free survival rates were 83. 30%,48. 61%,and 38. 29% in the LLR group and 78. 64%,51. 26%,and43. 01% in the OLR group; the 1-,3-,and 5-year overall survival rates were 97. 42%,95. 13%,and 89. 23% in the LLR group and96. 41%,94. 28%,and 90. 06% in the OLR group. There were no significant differences in these survival rates between the two groups( all P > 0. 05). Conclusion In patients with HCC complicated by liver cirrhosis,LLR helps to achieve rapid postoperative recovery and similar long-term outcome compared with OLR; therefore,it holds promise for clinical application.