To compare the efficacy of total laparoscopic and open surgery for recurrent hepatocellular carcinoma and the changes in the level of Chemokine (C-C motif) ligand 18 (CCL18).

The data of 66 cases with recurrent hepatocellular carcinoma who underwent surgical treatment from June 2013 to April 2016 were retrospectively analyzed. Patients were divided into laparoscopic group (n=36) and laparotomy group (n=30) according to different surgical procedures. SPSS 20.0 software was used for analysis. The intraoperative and postoperative indexes, pain scores, CCL18 levels and other measurement data were expressed as mean±standard deviation, compared with independent t test. The tumor recurrence rate, metastasis rate, survival rate were compared with chi-square test. The difference was statistically significant at P<0.05.

The operative time, intraoperative blood loss, time to get out of bed after operation and postoperative anal exhaustion time in the laparoscopy group were significantly lower than those in the laparotomy group (P<0.05). On the 1st, 3rd, 5th and 7th day after surgery, the VAS pain scores of the laparoscopy group were significantly lower than those of the laparotomy group (P<0.05). There was no significant difference in serum CCL18 levels between the two groups before surgery (P=0.868). Postoperatively, the serum levels of CCL18 in the laparoscopic group were significantly lower than those in the laparotomy group (P<0.05). There was no significant difference in recurrence rate, metastasis rate, and 2-year survival rate between the two groups (P>0.05).

The clinical effect of total laparoscopic resection in patients with recurrent liver cancer is better than open surgery. It can effectively reduce the operation time and intraoperative blood loss. The patients recover more quickly, and the postoperative pain was significantly relieved, which has certain clinical value.