Journal
EJSO
Volume 40, Issue 5, Pages 536-544Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2014.01.005
Keywords
Laparoscopic liver resection; Colorectal liver metastases; Oncological outcome
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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 kiss, morbidity rate and hospital stay. It provides comparable long-term oncological outcomes but can improve further resectability in patients with recurrent disease. (C) 2014 Elsevier Ltd. All rights reserved.
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