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After laparoscopic liver resection for colorectal liver metastases, age does not influence morbi-mortality

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Abstract

Background

Hepatectomy remains the only curative option in patients presenting with colorectal liver metastases (CLM). Although laparoscopic approach has improved postoperative morbidity and mortality rates, its suitability for patients of all age groups has yet to be confirmed. The aim of this study was to analyze postoperative outcomes following laparoscopic liver resection (LLR) in different age groups of patients presenting with CLM.

Methods

All patients who underwent LLR for CLM from 2008 to 2017 were reviewed. Patients were divided into four age groups: < 55, 55–65 years, 65–75 and > 75 years. Baseline and intraoperative characteristics as well as postoperative morbidity and mortality were compared between all four groups.

Results

Overall, 335 patients were included with 34 (10%), 113 (34%), 136 (41%) and 52 (15%) in < 55, 55–65, 65–75 and > 75 years subgroups. Baseline characteristics were similar between all four groups except for elevated pressure, dyslipidemia and ASA score which were higher in older patients. Regarding surgical procedures, major hepatectomy, uni- or bisegmentectomy and wedge resection were performed in 122 (36%), 87 (26%) and 126 (38%) patients, respectively, with no significant differences between age groups. Overall, 90-day postoperative mortality rate was nil and postoperative morbidity was similar between all four groups except for biliary fistula occurrence, which was higher in < 55 years patients (p = 0.006).

Conclusion

Short-term postoperative outcome following LLR for CLM does not seem to be affected by age. Curative laparoscopic treatment should therefore be considered whenever possible, regardless of patient age.

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Abbreviations

CLM:

Colorectal liver metastases

CRC:

Colorectal cancer

LLR:

Laparoscopic liver resection

ASA:

American Society of Anesthesiologists

BMI:

Body mass index

CT:

Computed tomography;

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Author information

Authors and Affiliations

  1. Department of Digestive Surgery and Surgical Oncology – Avicenne Hospital, Assistance Publique – Hôpitaux de Paris, Université Paris XIII, 125 rue de Stalingrad, 93000, Bobigny, France

    Alban Zarzavadjian Le Bian & Philippe Wind

  2. Department of Digestive, Oncological and Metabolic Surgery – Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Nicolas Tabchouri, Brice Gayet & David Fuks

  3. Université Paris Descartes, 15 rue de l’école de médecine, 75005, Paris, France

    Nicolas Tabchouri, Brice Gayet & David Fuks

  4. Department of Oncology - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Mostefa Bennamoun, Christophe Louvet & Candice Tubbax

  5. Department of Radiology and Medical Imaging - Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Anthony Sarran

  6. Department of Histopathology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Marine Lefevre

  7. Department of Anesthesiology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France

    Marc Beaussier

  8. Department of Geriatric Medicine, Coordination Unit of Geriatric Oncology, Avicenne Hospital, Assistance Publique – Hôpitaux de Paris, Université Paris XIII, 125 rue de Stalingrad, 93000, Bobigny, France

    Frédéric Pamoukdjian

  9. UPEC, DHU A-TVB, IMRB-EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit) Université Paris Est, 94000, Créteil, France

    Frédéric Pamoukdjian

Authors
  1. Alban Zarzavadjian Le Bian
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  2. Nicolas Tabchouri
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  7. Marine Lefevre
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  11. Brice Gayet
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  12. David Fuks
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Correspondence to Alban Zarzavadjian Le Bian.

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Disclosure

Regarding current study, Alban Zarzavadjian Le Bian, Nicolas Tabchouri, Mostefa Bennamoun, Christophe Louvet, Candice Tubbax, Anthony Sarran, Marine Lefevre, Marc Beaussier, Frédéric Pamoukdjian, Philippe Wind, Brice Gayet and David FUKS have no conflict of interest to declare.

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Zarzavadjian Le Bian, A., Tabchouri, N., Bennamoun, M. et al. After laparoscopic liver resection for colorectal liver metastases, age does not influence morbi-mortality. Surg Endosc 33, 3704–3710 (2019). https://doi.org/10.1007/s00464-019-06663-8

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