Laparoscopic liver resection versus open liver resection for recurrent
liver cancer: A systematic review and meta-analysis of PSM studies
Abstract
Background: Laparoscopic liver resection (LLR) has not been widely
accepted for recurrent liver cancer (RLC). This study aims to conduct a
systematic review of the current literature for determining LLR
effectiveness and safety for patients with RLC. Methods: Before April
2022, a comprehensive literature search was undertaken in Web of
Science, PubMed, and Embase relied on a specified search strategy for
eligible propensity score matching (PSM) studies comparing LLR or OLR.
Meta-analysis of operative times, duration of stay, mortality, blood
loss, overall survival rate, blood transfusion, recurrence-free survival
rate, and overall complications was undertaken using a
random/fixed-effects model. Results: Eight PSM studies of LLR versus OLR
were incorporated, including 1128 patients. The current meta-analysis
revealed nonsignificant variations between the two groups in overall
survival rate, operation time, blood transfusion, mortality, overall
complications, and long-term recurrence-free survival rate.
Alternatively, when LLR is compared to OLR, LLR results in lower blood
loss (p=0.002) and a shorter hospitalization (p=0.04). Conclusion:
Although both techniques appear equal, LLR seems to have certain
advantages over OLR. Notably, the evidence quality is generally confined
to cohort studies, necessitating the performance of a high-quality
randomized trial that compares both approaches. Keywords: Laparoscopic
surgery, Liver resection, Recurrent liver cancer, Propensity score
matching, Meta-analysis.