To explore the application value of three-dimensional reconstruction in laparoscopic hepatectomy for liver cancer.

Literature in Chinese or English about randomized controlled study (RCT), cohort study or case-control study of three-dimensional reconstruction combined with laparoscopic hepatectomy for liver tumors was retrieved in PubMed, Cochrane Library, Embase, SinoMed, CNKI, Wanfang and Chongqing VIP databases from the inception of database to February 2019. The Chinese and English searching terms included hepatoma, liver cancer, hepatectomy, laparoscope and three-dimensional reconstruction. Clinical data including perioperative condition and postoperative liver function were extracted for Meta-analysis.

8 articles of 534 patients were eventually included. Among them, 245 cases were assigned into the experimental group in which three-dimensional reconstruction was used and 289 cases in the control group. Meta-analysis showed that the operation time (MD=-36.48, 95%CI:-52.00 to -20.96, Z=4.61, P<0.05), intraoperative blood loss (MD=-109.36, 95%CI:-142.03 to -76.69, Z=6.56, P<0.05), incidence of postoperative complications (OR=0.42, 95%CI: 0.28 to 0.62, Z=4.38, P<0.05), length of postoperative hospital stay (MD=-3.31, 95%CI:-4.16 to -2.47, Z=7.66, P<0.05), postoperative ALT level (MD=-7.23, 95%CI: -8.39 to -6.07, Z=12.17, P<0.05), postoperative AST level (MD=-5.37, 95%CI:-8.59 to -2.14, Z=3.26, P<0.05) and postoperative TB level (MD=-2.84, 95%CI:-3.45 to -2.23, Z=9.09, P<0.05) significantly differed between two groups. Subgroup analysis showed that the heterogeneity of operation time, intraoperative blood loss and length of postoperative hospital stay was mainly caused by the difficulty of laparoscopic hepatectomy.

Application of three-dimensional reconstruction in laparoscopic hepatectomy for liver cancer can improve the surgical safety and efficacy, shorten the operation time, reduce the intraoperative blood loss and lower the risk of postoperative complications.