目的：系统评价腹腔镜肝切除术（LLR）与开腹肝切除术（OLR）治疗肝癌的近、远期疗效和安全性。 方法：检索相关期刊、资料、会议文献和学位论文数据库，收集比较LLR 与OLR 治疗肝癌疗效的 病例- 对照研究。按MOOSE 规范对纳入研究进行分析，提取数据并用RevMan 5.3 软件对数据进 行Meta 分析。 结果：最终共纳入15 篇病例- 对照研究，共1 246 例患者，LLR 组499 例，OLR 组747 例。Meta 分 析结果显示，LLR 组与OLR 组的手术时间，1、3、5 年生存率，1、3、5 年无瘤生存率，3 年肿瘤复 发率组间差异均无统计学意义（均P>0.05）；LLR 与OLR 相比术中出血量少、术后并发症发生率低、 围手术期死亡率低、术后住院天数少（均P<0.05）。 结论：LLR 可以达到与OLR 同样的根治效果，两者近、远期疗效无明显差异，且LLR 围手术期不良 事件少于OLR。
Meta-analysis of efficacy of laparoscopic versus open liver resection for liver cancer
Objective: To systematically assess the short- and long-term efficacy and safety of laparoscopic liver resection (LLR) and open liver resection (OLR) for liver cancer. Methods: The case-controlled studies comparing LLR and OLR for liver cancer were collected by searching the relevant databases covering scholarly journals, materials, conference proceedings, and dissertations. Data from selected studies were analyzed according to the MOOSE guidelines. After data extraction, a Meta-analysis was performed using RevMan 5.3 software. Results: Fifteen case-controlled studies were finally included, involving 1 246, with 499 cases in LLR group and 747 cases in OLR group. The results of Meta-analysis showed that there was no significant difference between LLR group and OLR group in operative time, 1-, 3-, and 5-year survival rate, 1-, 3-, and 5-year disease-free survival rate and 3-year recurrence rate (all P>0.05), while the intraoperative blood loss, incidence of postoperative complications, perioperative mortality and length of postoperative hospital stay were significantly reduced in LLR group compared with OLR group (all P<0.05). Conclusion: LLR offers the same radical resection for liver cancer as does OLR, with a similar short- and longterm efficacy but reduced perioperative adverse events.