Laparoscopic hepatectomy for primary hepatocellular carcinoma doesn’t affect rate of delayed recovery after anesthesia: a retrospective study

Purpose Despite the expansion of laparoscopic approach in the treatment of liver tumors, only a few studies referred to the effects that pneumoperitoneum might be associated with delayed recovery after anesthesia. This study aimed to evaluate the two surgical procedures to see if laparoscopic hepatectomy (LH) has less effects on post-anesthesia recovery and other short-term outcomes. Methods We retrospectively compared the postoperative intubation time and short-term outcomes of laparoscopic hepatectomy (LH) with those of open hepatectomy (OH) for hepatocellular carcinoma (HCC) in patients from January 2015 to December 2020. Data of patients’ baseline characteristics, intraoperative data and short-term postoperative data were collected. Results There were 218 and 356 patients in LH and OH groups, respectively. Factors associates with delayed anesthesia recovery included diameter of tumor ( P =0.010), preoperative pulmonary function ( P =0.023), preoperative ASA grade ( P =0.050), area of resection ( P =0.000), preoperative Child-Pugh score ( P =0.006), duration of operation ( P =0.000), intraoperation blood loss ( P =0.000), total fluid intake ( P =0.000) and intraoperative urea volume ( P =0.008). LH took longer operating time, however, caused less blood loss and less infusion. Rate of postoperative complications was less than OH group, and post-operation stay was shorter. Conclusion Method of surgery was not one of the factors that accounts for delayed emergence. LH doesn’t prolong time of intubation and on the contrary, given its advantages of minimally invasive abdominal operation compared with open techniques, reduced time to initiation of oral diet, faster return of gastrointestinal function, and shorter hospital stay, LH is the better choice.