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Eur J Surg Oncol. 2014 May;40(5):536-44. doi: 10.1016/j.ejso.2014.01.005. Epub 2014 Feb 2.

Laparoscopic liver resection compared to open approach in patients with colorectal liver metastases improves further resectability: Oncological outcomes of a case-control matched-pairs analysis.

Author information

1
Dept. of General & Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, De Pintelaan 185, 2K12 IC, 9000 Ghent, Belgium.
2
Dept. of General Surgery, Sant'Andrea Hospital, "La Sapienza" University of Rome, Italy.
3
Dept. of Gastroenterology-Abdominal Oncology Unit, Ghent University Hospital and Medical School, De Pintelaan 185, 9000 Ghent, Belgium.
4
Dept. of Pathology, Ghent University Hospital and Medical School, De Pintelaan 185, 9000 Ghent, Belgium.
5
Dept. of Radiology, Ghent University Hospital and Medical School, De Pintelaan 185, 9000 Ghent, Belgium.
6
Dept. of General & Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, De Pintelaan 185, 2K12 IC, 9000 Ghent, Belgium. Electronic address: roberto.troisi@ugent.be.

Abstract

AIMS:

Liver resection is considered the standard treatment of colorectal metastases (CRLM). However, to date, no long term oncological results and data regarding repeat hepatectomy after laparoscopic approach are known. The aim of this study is to analyze single center long-term surgical and oncological outcomes after liver resection for CRLM.

METHODS:

A total of 57 open resections (OR) were matched with 57 laparoscopic resections (LR) for CRLM. Matching was based mainly on number of metastases, tumor size, segmental position of lesions, type of hepatectomy and type of resection.

RESULTS:

Morbidity rate was significantly less in the LR group (p = 0.002); the length of hospital stay was 6.5 ± 5 days for the LR group and 9.2 ± 4 days for the OR group (p = 0.005). After a median follow up of 53.7 months for the OR group and 40.9 months for the LR group, the 5-y overall survival rate was 65% and 60% respectively (p = 0.36) and the 5-y disease free survival rate was 38% and 29% respectively (p = 0.24). More patients in the LR group received a third hepatectomy for CRLM relapse than in the OR group (80% vs. 14.3% respectively; p = 0.015).

CONCLUSIONS:

Laparoscopic resection for CRLM offers advantages in terms of reduced blood loss, morbidity rate and hospital stay. It provides comparable long-term oncological outcomes but can improve further resectability in patients with recurrent disease.

KEYWORDS:

Colorectal liver metastases; Laparoscopic liver resection; Oncological outcome

PMID:
24555996
DOI:
10.1016/j.ejso.2014.01.005
[Indexed for MEDLINE]
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