Survival analysis of laparoscopic and laparotomy hepatectomy for pediatric liver neoplasm: a single-center retrospective cohort study.

OBJECTIVE: To evaluate the efficacy and postoperative survival following laparoscopic and laparotomy hepatectomy of pediatric liver neoplasm (PLN). METHODS: A retrospective analysis was conducted on 180 patients who underwent hepatectomy of PLN in our center between January 2014 and May 2025. Demographic information, perioperative clinical data, postoperative liver function recovery, complications, and survival outcomes were collected to evaluate the efficacy, postoperative complications, and survival rates after laparoscopic and laparotomy hepatectomy of PLN. RESULTS: In this study, 89 patients (49.44%) were male and 91 (50.56%) were female. The median age at surgery was 5.7 years. 66 patients (36.67%) were diagnosed with benign liver neoplasms (BLN), and 114 patients (63.33%) with malignant liver neoplasms (MLN). Laparoscopy was performed in 83 patients (46.11%), while laparotomy was performed in 97 patients (53.89%). In the BLN group, there were no significant differences between the laparoscopic and laparotomy groups in terms of postoperative liver function recovery or complication rates. The postoperative survival rate was 100% in both groups. However, the length of hospital stay was significantly shorter in the laparoscopic group (P < 0.001). In the MLN group, there were no significant differences in postoperative liver function recovery or complication rates between the two surgical approaches. However, the laparoscopic group had a significantly longer operative time (P = 0.009), more frequent Pringle maneuver (P < 0.001). The 5-year cumulative survival rate was 78.13% in the laparoscopic group and 81.23% in the laparotomy group, with no significant difference between the two approaches (P = 0.732). CONCLUSION: Surgical treatment for PLN yields favorable outcomes. Laparoscopy is recommended for BLN or MLN with localized lesions. However, for large MLN that encase vessels or show diffuse infiltration, laparotomy is recommended.