Multicenter randomized controlled trial of laparoscopic versus open hemihepatectomy

The randomized controlled ORANGE II PLUS trial, at 16 centers in Europe, compared outcomes after laparoscopic versus open liver resection, mainly for primary or metastatic cancer. The median time to functional recovery (primary endpoint) was 4 days in the laparoscopy group versus 5 days in the open surgery group (p<0.001). There was no significant difference between the groups in the incidence of major complications. Both global health status and body image were better in the laparoscopy group. Among patients with cancer there was no difference between the groups for R0 resection margin status, with a shorter time to adjuvant systemic therapy in the laparoscopy group (median 46.5 versus 62.8 days; p=0.009). The authors conclude that among patients undergoing hemihepatectomy, the laparoscopic approach resulted in a shorter time to functional recovery compared with open surgery.