Abstract
Background
Minimally invasive liver resection (MILR) for colorectal liver metastases (CRLM) is gaining widespread acceptance. However, data are still lacking on the feasibility, long- and short-term outcomes of laparoscopic major hepatectomy (i.e., three or more liver segments).
Methods
Between October 2002 and December 2008, prospectively collected data of 117 patients who underwent major liver resection [97 open (OMLR) and 20 laparoscopic (LMLR) procedures] for CRLM were analyzed. Twenty patients in the LMLR group were matched with 20 patients of the OMLR based on 13 parameters. We compared the long- and short-term outcomes between these two groups.
Results
Median duration of surgery was 257.5 (range 75–360) min in LMLR versus 232.5 (range 120–400) min in OMLR (P = 0.228). Median blood loss during surgery was 550 ml in each group (range 100–4,000 vs. 100–2,500 ml, P = 0.884). There was no statistically significant difference in the rate of postoperative complications (both severity and location). Median magnitude of tumor-free resection margin was 7.5 versus 5.5 mm in the laparoscopy versus open group, respectively (P = 0.651). Median disease-free survival (DFS) of the entire study population was 18.4 months [95% confidence interval (CI) 11.9–50.0 months]. Median overall survival (OS) was 50.7 months (95% CI 36.2 months to undetermined). The estimated DFS and OS rates at 1, 2, and 5 years were comparable in the two groups (P = 0.637 and 0.872, respectively).
Conclusion
Laparoscopic MLR for selected CRLM is feasible and might result in comparable oncologic outcomes as in open liver resection.
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Disclosure
Authors H. Topal, J. Tiek, R. Aerts, and B. Topal have no conflicts of interest or financial ties to disclose.
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Topal, H., Tiek, J., Aerts, R. et al. Outcome of laparoscopic major liver resection for colorectal metastases. Surg Endosc 26, 2451–2455 (2012). https://doi.org/10.1007/s00464-012-2209-4
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DOI: https://doi.org/10.1007/s00464-012-2209-4