PDF(Pubmed)
Abstract：
BACKGROUND: Although laparoscopic hepatectomy (LH) and radiofrequency ablation (RFA) are the 2 principal minimally invasive surgical approaches and the first line of treatments for patients with hepatocellular carcinoma (HCC). It is not clear which one has greater safety and efficacy. In this meta-analysis, we aim to compare the safety and effectiveness of LH versus RFA for patients with HCC, especially where perioperative and postoperative outcomes differrent.
METHODS: In PROSPERO, a meta-analysis with registration number CRD42021257575 was registered. Using an established search strategy, we systematically searched Web of Science, PubMed, and Embase to identify eligible studies before June 2023. Data on operative times, blood loss, length of stay, overall complications, overall survival (OS) and recurrence-free survival (RFS) were subjected to meta-analysis.
RESULTS: Overall, the present meta-analysis included 8 retrospective and 6 PSM studies comprising 1,848 patients (810 and 1,038 patients underwent LH and RFA). In this meta-analysis, neither LH nor RFA showed significant differences in 1-year and 3-year OS rate and 5-year RFS rate. Despite this, in comparison to the RFA group, LH resulted in significantly higher 1-year(p<0.0001) and 3-year RFS rate (p = 0.005), higher 5-year OS rate (p = 0.008), lower local recurrence rate (p<0.00001), longer length of stay(LOS) (p<0.0001), longer operative time(p<0.0001), more blood loss (p<0.0001), and higher rate of complications (p=0.001).
CONCLUSIONS: Comparative studies indicate that LH seemed to provide better OS and lower local recurrence rate, but higher complication rate and longer hospitalization.
METHODS: In PROSPERO, a meta-analysis with registration number CRD42021257575 was registered. Using an established search strategy, we systematically searched Web of Science, PubMed, and Embase to identify eligible studies before June 2023. Data on operative times, blood loss, length of stay, overall complications, overall survival (OS) and recurrence-free survival (RFS) were subjected to meta-analysis.
RESULTS: Overall, the present meta-analysis included 8 retrospective and 6 PSM studies comprising 1,848 patients (810 and 1,038 patients underwent LH and RFA). In this meta-analysis, neither LH nor RFA showed significant differences in 1-year and 3-year OS rate and 5-year RFS rate. Despite this, in comparison to the RFA group, LH resulted in significantly higher 1-year(p<0.0001) and 3-year RFS rate (p = 0.005), higher 5-year OS rate (p = 0.008), lower local recurrence rate (p<0.00001), longer length of stay(LOS) (p<0.0001), longer operative time(p<0.0001), more blood loss (p<0.0001), and higher rate of complications (p=0.001).
CONCLUSIONS: Comparative studies indicate that LH seemed to provide better OS and lower local recurrence rate, but higher complication rate and longer hospitalization.
摘要：
背景：尽管腹腔镜肝切除术（LH）和射频消融（RFA）是两种主要的微创手术方法，也是肝细胞癌（HCC）患者的一线治疗方法。尚不清楚哪一种具有更大的安全性和有效性。在这个荟萃分析中，我们的目的是比较LH和RFA对HCC患者的安全性和有效性，尤其是围手术期和术后结局不同的地方。
方法：在PROSPERO中，注册编号为CRD42021257575的荟萃分析被注册.使用既定的搜索策略，我们系统地搜索了WebofScience,PubMed,和Embase在2023年6月之前确定合格的研究。操作时间数据,失血,逗留时间,整体并发症,对总生存期(OS)和无复发生存期(RFS)进行荟萃分析.
结果：总体而言，本荟萃分析包括8项回顾性研究和6项PSM研究,包括1,848例患者(接受LH和RFA的患者分别为810例和1,038例).在这个荟萃分析中，LH和RFA均未显示1年和3年OS率和5年RFS率的显着差异。尽管如此,与RFA组相比，LH导致显著较高的1年（p<0.0001）和3年RFS率（p=0.005），较高的5年OS率(p=0.008)，较低的局部复发率（p<0.00001），较长的停留时间（LOS）（p<0.0001），手术时间更长（p<0.0001），更多的失血（p<0.0001），并发症发生率较高(p=0.001)。
结论：比较研究表明，LH似乎提供更好的OS和更低的局部复发率，但并发症发生率较高，住院时间较长。
方法：在PROSPERO中，注册编号为CRD42021257575的荟萃分析被注册.使用既定的搜索策略，我们系统地搜索了WebofScience,PubMed,和Embase在2023年6月之前确定合格的研究。操作时间数据,失血,逗留时间,整体并发症,对总生存期(OS)和无复发生存期(RFS)进行荟萃分析.
结果：总体而言，本荟萃分析包括8项回顾性研究和6项PSM研究,包括1,848例患者(接受LH和RFA的患者分别为810例和1,038例).在这个荟萃分析中，LH和RFA均未显示1年和3年OS率和5年RFS率的显着差异。尽管如此,与RFA组相比，LH导致显著较高的1年（p<0.0001）和3年RFS率（p=0.005），较高的5年OS率(p=0.008)，较低的局部复发率（p<0.00001），较长的停留时间（LOS）（p<0.0001），手术时间更长（p<0.0001），更多的失血（p<0.0001），并发症发生率较高(p=0.001)。
结论：比较研究表明，LH似乎提供更好的OS和更低的局部复发率，但并发症发生率较高，住院时间较长。
