Laparoscopic vs. Open Liver Resection for Benign and Malignant Solid Liver Tumors: A Case Matched Study

Mohammad Kazem Fallahzadeh, MD, Gazi B Zibari, MD, FACS, FICS, Alireza Hamidian Jahromi, MD, Quyen Chu, MD, FACS, Runhua Shi, MD, PhD, Hosein Shokouh-Amiri, MD, FACS, FICS

Department of Surgery, Louisiana State University Health Sciences Center-Shreveport

Introduction

Laparoscopic liver resection (LLR) is gaining more popularity among surgical community as an alternative option to open liver resection (OLR) for the treatment of benign and malignant liver lesions. The aim of our study was to compare the surgical and oncological outcomes of LLR vs. OLR in benign and malignant solid liver tumors in a case-matched study.

Methods

In this IRB approved study, charts of 497 patients with liver lesions who had LLRs or OLR in our center were retrospectively reviewed. Among them, 54 consecutive patients with benign or malignant solid liver tumors who had LLR were matched with similar number of patients with OLR based on the pathology and extent of liver resection. Additionally, the surgical and oncological outcomes such as OR time, amount of blood transfusion requirement, free resection margin rate, length of stay, complication rate, perioperative mortality and survival were compared between two groups. Perioperative mortality was defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital, and after 30 days during the same hospitalization subsequent to the operation. Independent-sample t-test, chi-square and Fisher’s exact tests and log-rank test were used to compare the data between two groups.

Results

Demographics, pathologoical characteristics of tumor and extent of liver resection were similar between the two groups. Twenty nine (54%) patients in each group had malignant lesions. There were no statistically significant differences between the two groups in terms of OR time, amount of blood transfusion requirement, free resection margin or post-op complication rate or survival. However, length of stay was significantly lower in laparoscopic group (5.9 vs. 9 days, P<0.05). While no perioperative mortality was observed in patients with benign tumors, in patients with malignant tumors, 2 died perioperatively in each group.

Conclusion

Our results in accordance with previous studies demonstrate that while the oncological outcomes of LLR and OLR are comparable, LLR patients have shorter length of stay. Possible pros and cons of LLR vs. OLR for the treatment of solid liver tumors should be further compared in randomized controlled trials.

Session: Podium Presentation

Program Number: S003