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Chirurgie 1. Juni 2012

Laparoscopic hepatectomy: an alternative to open surgery for colorectal liver metastases?

BACKGROUND: It is not clear to what extent laparoscopic hepatectomies can replace conventional open liver resections for colorectal cancer liver metastases (CLM) following the same parenchymal sparing strategy. METHODS: Preoperative imaging results of 254 consecutive open liver resections for CLM were retrospectively analyzed regarding rates of potential laparoscopic resections and differences in the surgical strategy. RESULTS: Group A: the same strategy as in open surgery seemed possible in 77 (30.3%) resections; group B: a different laparoscopic strategy appeared necessary in 54 (21.3%) resections; and group C: laparoscopic resection was currently not recommendable in 123 (48.4%) resections. CONCLUSIONS: Laparoscopic resection seemed a feasible alternative to open surgery in 131 cases (groups A+B, 52%). Potential disadvantages of a more liberal use of large anatomical resections should limit laparoscopic surgery to patients undergoing the same type of resection as in open surgery (group A, 30.3%).

K. Kaczirek, P. Muckhoff, C. Koelblinger, D. Tamandl, M. Bodingbauer, T. Gruenberger, European Surgery 3/2012

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