Current status of radical laparoscopy for treating hepatocellular carcinoma with portal hypertension

Table 1 Overall survival rates obtained from research articles comparing therapeutic efficacy between laparoscopy and non-laparoscopy for treatment of hepatocellular carcinoma patients with portal hypertension

Ref.	Country	Number of patients	Proportion of cirrhosis	Causes and their proportion of liver cirrhosis	Diagnostic method of PHT	Proportion of PHT	1-yr overall survival	3-yr overall survival	5-yr overall survival	Statistical significance
Di Sandro et al[42], 2018	Italy	LLR/OLR, 75/75	All	Virus/Alcohol/Virus + Alcohol/Other, 92/24/16/18	Non-invasive tests	PartialLLR ≈ OLR	LLR/OLR, 98%/90%	LLR/OLR, 76%/ 68%	LLR/OLR, 60%/58%	NSD
Le Roux et al[67], 2017	France	LLR/OLR, 38/24	All	Virus/Alcohol/NASH/Other, 6/29/21/6	Non-invasive tests	PartialLLR ≈ OLR	NA	NA	NA	NA
El-Gendi et al[60], 2017	Egypt	LLR/OLR, 25/25	All	Virus, 50	Non-invasive tests	PartialLLR ≈ OLR	NA	NA	NA	NA
Tarantino et al[40], 2017	Italy	LLR/OLR, 13/51	All	Virus/Alcohol/NASH/Other, 59/1/2/2	HVPG + Non-invasive tests	PartialLLR ≈ OLR	NA	NA	NA	NA
Sposito et al[61], 2016	Italy	LLR/OLR, 43/43	All	Virus/Other, 67/19	Non-invasive tests	Partial	LLR/OLR, 98%/88%	LLR/OLR, 75%/79%	LLR/OLR, 38%/46%	NSD
Harada et al[43], 2016	Japan	LLR/OLR, 20/48	All	Virus/Other, 58/10	Non-invasive tests	All	LLR/OLR, 100%/98%	LLR/OLR, 90%/68%	LLR/OLR, 90%/54%	NSD
Memeo et al[48], 2014	France	LLR/OLR, 45/45	All	Virus/Alcohol, 64/26	Non-invasive tests	PartialLLR ≈ OLR	LLR/OLR, 88%/63%	LLR/OLR, 59%/44%	LLR/OLR, 12%/22%	NSD
Truant et al[39], 2011	France	LLR/OLR, 36/53	All	Virus/Alcohol/Other, 17/55/17	HVPG + Non-invasive tests	PartialLLR ≈ OLR	LLR/OLR, 98%/85%	LLR/OLR, 80%/64%	LLR/OLR, 70%/46%	NSD
Belli et al[44], 2009	Italy	LLR/OLR, 54/125	All	Virus/Other, 175/4	Non-invasive tests	PartialLLR ≈ OLR	LLR/OLR, 94%/94%	LLR/OLR, 67%/62%	NA	NSD
Berger et al[68], 2018	America	LRFA/ORFA, 478/177	All	NA	Non-invasive tests	All	NA	NA	NA	NA
Casaccia et al[50], 2017	Italy	LLR/LRFA, 22/24	All	Virus/Alcohol/Virus + Alcohol/Other, 33/9/1/2	Non-invasive tests	Partial	LLR/LRFA, 96%/88%	LLR/LRFA, 84%/54%	LLR/LRFA, 70%/32%	SD
Santambrogio et al[69], 2015	Italy	(LLR+OLR)/LRFA, 76/76	All	Virus/Other, 122/30	Non-invasive tests	Partial	(LLR + OLR)/LRFA, 94%/88%	(LLR + OLR)/LRFA, 82%/62%	(LLR + OLR)/LRFA, 69%/48%	SD

HCC: Hepatocellular carcinoma; HVPG: Hepatic venous pressure gradient; LLR: Laparoscopic liver resection; NA: Not available; NASH: Non-alcoholic steatohepatitis; NSD: No significant difference; OLR: Open liver resection; PHT: Portal hypertension; SD: Significant difference.

Table 2 Intraoperative and postoperative outcomes obtained from articles comparing therapeutic efficacy between laparoscopy and non-laparoscopy for treatment of hepatocellular carcinoma patients with portal hypertension

Ref.	Number of patients	Minor hepatectomy, < 3 adjacent segments	Major hepatectomy, ≥ 3 adjacent segments	Conversion laparotomy rate	Operative blood loss	Transfusion requirements	Margins, cm	R0 resection rate	Operative time	Length of stay	Complications
Di Sandro et al[42], 2018	LLR/OLR, 75/75	LLR/OLR, 74/73	LLR/OLR, 1/2	0 (0)	LLR < OLR	Equivalent	LLR > OLR	Equivalent	Equivalent	LLR < OLR	LLR < OLR
Le Roux et al[67], 2017	LLR/OLR, 38/24	LLR/OLR, 25/23	LLR/OLR, 13/1	NA	Equivalent	NA	NA	NA	NA	LLR < OLR	LLR < OLR
El-Gendi et al[60], 2017	LLR/OLR, 25/25	NA	NA	0 (0)	Equivalent	Equivalent	Equivalent	Equivalent	Equivalent	LLR < OLR	Equivalent
Tarantino et al[40], 2017	LLR/OLR, 13/51	LLR/OLR, 13/51	NO	3 (23.1%)	Equivalent	NA	NA	Equivalent	Equivalent	LLR < OLR	LLR < OLR
Sposito et al[61], 2016	LLR/OLR, 43/43	LLR/OLR, 42/41	LLR/OLR, 1/2	2 (4.7%)	Equivalent	NA	Equivalent	Equivalent	Equivalent	LLR < OLR	LLR < OLR
Harada et al[43], 2016	LLR/OLR, 20/48	LLR/OLR, 20/45	LLR/OLR, 0/3	NA	LLR < OLR	Equivalent	NA	NA	LLR < OLR	NA	Equivalent
Memeo et al[48], 2014	LLR/OLR, 45/45	LLR/OLR, 43/43	LLR/OLR, 2/2	NA	Equivalent	Equivalent	NA	NA	LLR < OLR	LLR < OLR	LLR < OLR
Truant et al[39], 2011	LLR/OLR, 36/53	LLR/OLR, 36/53	NO	7 (19.4%)	Equivalent	Equivalent	Equivalent	NA	Equivalent	LLR < OLR	Equivalent
Belli et al[44], 2009	LLR/OLR, 54/125	LLR/OLR, 51/86	LLR/OLR, 3/39	4 (7.4%)	LLR < OLR	LLR < OLR	LLR > OLR	LLR > OLR	LLR < OLR	Equivalent	LLR < OLR
Berger et al[68], 2018	LRFA/ORFA, 478/177	NA	NA	NA	NA	NA	NA	NA	LRFA < ORFA	LRFA < ORFA	LRFA < ORFA
Casaccia et al[50], 2017	LLR/LRFA, 22/24	NA	NA	NA	NA	NA	NA	NA	NA	NA	NA
Santambrogio et al[69], 2015	(LLR+OLR)/LRFA, 76/76	NA	NA	8 (27.6%)	NA	NA	NA	NA	NA	NA	NA

HCC: Hepatocellular carcinoma; LRFA: Laparoscopic radiofrequency ablation; LLR: Laparoscopic liver resection; NA: Not available; OLR: Open liver resection; ORFA: Open radiofrequency ablation; PHT: Portal hypertension; R0: Complete excision with all margins negative.