4.5 Article

A Comparison between Open and Minimally Invasive Techniques for the Resection of Colorectal Liver Metastasis

Journal

HEALTHCARE
Volume 10, Issue 12, Pages -

Publisher

MDPI
DOI: 10.3390/healthcare10122433

Keywords

liver metastasis; colorectal cancer; minimally invasive surgery; implementation of liver surgery

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This study compared the short- and long-term outcomes of open surgery and minimally invasive surgery for the treatment of colorectal cancer liver metastasis, with results showing that minimally invasive techniques are safe and feasible, although open surgery had higher postoperative complication rates and longer hospital stays.
The liver is the most common site of colorectal cancer metastasis. Liver surgery is a cornerstone in treatment, with progressive expansion of minimally invasive surgery (MIS). This study aims to compare short- and long-term outcomes of open surgery and MIS for the treatment of colorectal adenocarcinoma liver metastasis during the first three years of increasing caseload and implementation of MIS use in liver surgery. All patients treated between November 2018 and August 2021 at Careggi Teaching Hospital in Florence, Italy, were prospectively entered into a database and retrospectively reviewed. Fifty-one patients were resected (41 open, 10 MIS). Considering that patients with a significantly higher number of lesions underwent open surgery and operative results were similar, postoperative morbidity rate and length of hospital stay were significantly higher in the open group. No differences were found in the pathological specimen. The postoperative mortality rate was 2%. Mean overall survival and disease-free survival were 46 months (95% CI 42-50) and 22 months (95% CI 15.6-29), respectively. The use of minimally invasive techniques in liver surgery is safe and feasible if surgeons have adequate expertise. MIS and parenchymal sparing resections should be preferred whenever technically feasible.

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