Laparoscopic versus open left hemihepatectomy for hepatocellular carcinoma: a propensity score matching analysis

• Published in: Translational cancer research Vol. 9; no. 9; pp. 5484 - 5492
• Main Authors: Yi, Yong, Weng, Jialei, Zhou, Chenhao, Liu, Gao, Ren, Ning
• Format: Journal Article
• Language: English
• Published: China AME Publishing Company 01.09.2020
• Subjects: Original; Laparoscopic left hemihepatectomy (LLH); perioperative outcomes; hepatocellular carcinoma (HCC)
• ISSN: 2218-676X; 2219-6803
• DOI: 10.21037/tcr-20-1573

Despite the increasing application of laparoscopic hepatectomy (LH) for hepatocellular carcinoma (HCC), laparoscopic left hemihepatectomy (LLH) remains a relatively rare surgery and comparison of perioperative and oncological outcomes between LLH and open left hemihepatectomy (OLH) is lacking. A total of 276 HCC patients who underwent either LLH or OLH between January 2008 and November 2019 were enrolled in this retrospective observational study and a 1:2 propensity score matching (PSM) was performed between LLH and OLH groups. Patients in LLH group had smaller tumor size (P=0.001) and earlier TNM staging (P=0.022) before matching. Despite the similar transfusion rate after matching, patients undergoing LLH (n=27) experienced less intraoperative blood loss (100.0 versus 200.0 mL; P=0.034) and application of hepatic portal occlusion (11.1% versus 63.5%; P<0.001) compared to those in OLH group (n=52). There were no statistical differences of resection margin and incidence of complications between the groups. The overall survival (OS) and disease-free survival (DFS) of patients in LLH group were comparable to OLH group (3-year OS rate: 75.0% versus 84.9%; 1-year DFS rate: 92.3% versus 92.2%). LLH may be a feasible and safe alternative to OLH for selected HCC cases, providing potential short-term benefits without compromising oncologic adequacy and prognosis.