RESUMEN
Objective To compare the curative effect and short-term benefits of laparoscopic liver resection with open liver resection in elderly patients with malignant liver tumors and medical comorbidities.Methods Patients aged 70 and over who received liver resections for malignant liver tumors between January and October 2015 were enrolled.The perioperative outcomes of 17 patients with laparoscopic approach were matched and compared with those of 34 patients with conventional open approach in a 1:2 ratio.Results There was no significant difference found between the two groups with regard to age,gender,incidence of comorbid illness,hepatitis B positivity,and Child-Pugh grading of liver function.The median tumor size was 3 cm for both groups.The types of liver resection were similar between the two groups with no significant difference in the duration of operation (laparoscopic: 195 min vs.open: 210 min,P=0.436).The perioperative blood loss was 150 mL in the laparoscopic group and 330 mL in the open group (P=0.046) with no significant difference in the number of patients with blood transfusion.The duration of hospital stay was 6 days (3-15 days) for the laparoscopic group and 8 days (5-105 days) for the open group (P=0.005).Conclusion Laparoscopic liver resection is safe and feasible for elderly patients.The short-term benefits of laparoscopic approach proves to be evident for geriatric oncological liver surgery.
RESUMEN
Objective To explore the short-term and long-term efficacy of laparoscopic versus open liver resection(LLR)in the treatment of hepatocellular carcinoma(HCC). Methods The perioperative and follow-up data ofLLR(n = 43)and OLR(n = 73)for the treatment of HCC at the same period were analyzed respectively. Results There were no significant differences in the age,gender,Child-Pugh classification,liver cirrhosis, AFP,and hepatic virus affection between the 2 groups. 1 case in the LLR group was converted for the open surgery and another one case in the OLR group died in the perioperative time. However ,compared with OLR group ,the intraoperative blood loss of LLR group(P 0.05). The first and third year disease-free survival rates were 82.2%,53.8%for LLR and 91.5%,75.9%for OLR,respectively(χ2=0.55,P=0.46). The first and third 5 year overall survival rates were 94.2%,79.3%for LLR and 94.9%,47.3%for OLR,respectively(χ2=1.06, P=0.30). Conclusion LLR for HCC treatment is a safe and effective way with the advantages of minimal opera-tive trauma,quick recovery and significant short-term efficacy.