Short-Term Effectiveness and Safety of Laparoscopic versus Open Left Hepatectomy for Primary Cancer: A Systematic Review

Objective To evaluate the short-term effectiveness and safety of laparoscopic versus conventional open left hepatectomy.Methods Databases including CENTRAL(Issue 1,2012),MEDLINE/PubMed(1978 to 2012),EMbase(1966 to 2012),CBM(1978 to 2012),CNKI(1979 to 2012) and the Chinese Medical Association Figures Journal Systems(1990 to 2012) were searched to collect clinical trials on laparoscopic versus conventional open left hepatectomy.Relevant proceedings and references of the included studies were also retrieved manually.According to the inclusion criteria,two reviewers independently screened literature,extracted data and assessed quality.Then meta-analysis was conducted using RevMan5.0 software.Results No randomized controlled trials were collected,and a total of 5 clinical concurrent controlled trials involving 319 patients were included finally.The results of meta-analysis showed that,compared with the conventional open group,the laparoscopic group was longer in the operation time(WMD=40.89,95%CI 29.39 to 55.38,P0.000 01),and was lower in the intraoperative blood loss(WMD= 107.84,95%CI 208.96 to 6.73,P0.04);but there was no significant difference between the two groups in terms of hospital stays(WMD= 3.78,95%CI 9.60 to 2.04,P=0.20) or postoperative complications(WMD=0.69,95%CI 0.37 to 1.29,P=0.25).Conclusion As a minimally invasive technique,laparoscopic left hepatectomy has advantages of small abdominal incision and less intraoperative blood loss,and it is helpful to improve the quality of life for patients.Due to the limitation of quantity and quality of the included studies,it is hard to estimate the impact of bias on the reliability of this conclusion.We advise to perform more high quality,large scale and multicenter studies with adequate follow-up in the future.