Short‐ and Long‐Term Outcomes of Single‐Incision Laparoscopic Hepatectomy: A Matched Cohort Analysis

TL;DR

This study compares short- and long-term outcomes of single-incision and multi-port laparoscopic liver surgery for small tumors, finding similar results in both approaches.

Contribution

The study provides evidence that single-incision laparoscopic hepatectomy is as effective as the multi-port method for selected cases.

Findings

Single-incision and multi-port laparoscopic hepatectomy had similar operative times and blood loss.

Postoperative hospital stay and complication rates were comparable between the two surgical approaches.

For hepatocellular carcinoma, 5-year survival rates were similar in both groups.

Abstract

Single‐incision laparoscopic hepatectomy has been introduced to reduce surgical invasiveness, but its short‐term and long‐term outcomes in malignant cases have not been fully elucidated. This study aimed to evaluate its impact on short‐ and long‐term outcomes of laparoscopic hepatectomy.

This retrospective study included patients who underwent laparoscopic partial hepatectomy or left lateral sectionectomy for tumors with diameters < 5 cm, located in segments 2–6, between July 2009 and April 2019. Single‐incision and multi‐port procedures were matched one‐to‐one based on clinical factors, and short‐term outcomes were compared. Long‐term outcomes were also analyzed for hepatocellular carcinoma cases.

A total of 136 patients were included: 20 in the single‐incision group (17 with hepatocellular carcinoma) and 116 in the multi‐port group (69 with hepatocellular carcinoma). Within the matched cohort, compared to the multi‐port group, the single‐incision group showed comparable operative time (179 min in the single‐incision group vs. 185 min in the multi‐port group, p = 0.133) and blood loss (9 vs. 20 mL, p = 0.076). These groups did not significantly differ in postoperative hospital stay (12 vs. 12 days, p > 0.99) or complication rate (5.0% vs. 10.0%, p > 0.99). Among matched hepatocellular carcinoma cases, the two groups showed comparable 5‐year disease‐free survival (52.9% vs. 40.5%, p = 0.653) and overall survival (82.4% vs. 68.2%, p = 0.415).

Compared with the multi‐port approach, single‐incision laparoscopic hepatectomy showed comparable and equivalent short‐ and long‐term outcomes. This procedure can be considered a safe and effective option for selected cases.

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