Identical oncological results with lower perioperative morbidity after laparoscopic liver resection: Results of a matched pair analysis

Abstract

Background: Laparoscopic liver resection belongs to the standard repertoire in hepatobiliary surgery. The advantages and disadvantages are still the subject of controversial discussion. Objective: The aim of the study was to compare the perioperative and long-term outcomes of laparoscopic and open liver resections. Material and methods: All patients who underwent liver resection in the Department of Surgery at the certified liver center of the municipal hospital Karlsruhe were analyzed. From a total of 268 hepatic resections 65 laparoscopic liver resections were identified and matched 1:1 with 65 open resections, based primarily on the extent of the resection and secondarily on diagnosis, age and gender of the patients. The demographic data, comorbidities, perioperative and long-term outcomes were compared. Results: Both groups had comparable demographic parameters and comorbidities. Operation time, duration of intensive care stay and percentage of negative resection margins were comparable in both groups. The 30-day mortality was 0% and 90-day mortality 1.5% in both groups. The laparoscopic group showed lower intraoperative and postoperative transfusion rates (p < 0.001), shorter hospital stay (p < 0.001) and lower overall morbidity (p < 0.001). The 1-, 3- and 5-year overall and tumor-free survival of patients with colorectal liver metastases was comparable (p = 0.984; p = 0.947). The same applied for patients with hepatocellular carcinomas (p = 0.803; p = 0.935). Conclusion: Laparoscopic liver resections have identical long-term outcomes with lower overall morbidity. Laparoscopic liver resections offer advantages regarding transfusion rates, length of hospital stay and postoperative complications.