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

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.