Efficacy and safety of laparoscopic hepatectomy for malignant liver tumors in unfavorable regions
10.3760/cma.j.cn113884-20250126-00032
- VernacularTitle:腹腔镜肝切除术治疗特殊部位肝恶性肿瘤的疗效与安全性
- Author:
Junfeng CHENG
1
;
Xuemin LI
1
;
Xiaokang WU
1
;
Shian YU
1
Author Information
1. 浙江大学医学院附属金华医院肝胆胰外科，金华 321000
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Laparoscopes;
Hepatectomy;
Treatment outcome;
Propensity score matching
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(8):579-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) for malignant liver tumors in unfavorable regions using propensity score matching (PSM) analysis.Methods:Clinical data of 181 patients with malignant liver tumors in unfavorable regions undergoing hepatic resection at the Department of Hepatopancreatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, between January 2013 and February 2019, including 130 males and 51 females, aged (56.4±12.5) years. Patients were divided into two groups according to surgical approach: the OH group ( n=128) and LH group ( n=53). Clinical parameters including age, gender, hepatitis B history, operative time, and postoperative complications were recorded. PSM (1∶1 nearest neighbor matching with a caliper width of 0.04) was performed using surgical approach as the dependent variable and covariates as independent variables. Survival analysis was conducted via the Kaplan-Meier method, with intergroup survival rates were compared using log-rank tests. Results:Prior to PSM, significant intergroup differences were observed in age, hepatitis B status, cirrhosis, and microvascular invasion (all P<0.05). After PSM, 74 patients (37 per group) achieved balance in baseline characteristics (all P>0.05). Post-PSM analysis revealed significantly shorter postoperative hospitalization in LH group compared to that in OH group [9(7, 10) d vs. 11(10, 13) d, P<0.05]. No perioperative mortality occurred in either group. The OH group exhibited a higher postoperative complication rate than the LH group did [37.8% (14/37) vs. 16.2% (6/37), χ2=4.39, P=0.036]. No significant differences were observed in cumulative recurrence-free survival ( χ2=0.44, P=0.508) or overall survival ( χ2<0.01, P=0.997) between groups. Conclusion:For malignant liver tumors in unfavorable regions, LH compared favourable open surgery, regarding the reduced invasiveness, shorter hospitalization, and lower complication rates, while maintaining comparable oncological outcomes. LH represents a safe and feasible surgical approach in selected cases.
