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Laparoscopic versus open liver resections for colorectal cancer liver metastases: short term results


Authors: Z. Šubrt 1;  A. Ferko 2;  M. Vošmik 3 ;  M. Linter-Kapišinská 4;  M. Oliverius 1;  R. Gürlich 1
Authors place of work: Chirurgická klinika 3. lékařské fakulty Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady 1;  Chirurgická klinika a Transplantačné centrum, Jesseniova lekárska fakulta, Martin 2;  Klinika onkologie a radioterapie Fakultní nemocnice Hradec Králové 3;  Chirurgické oddělení, Oblastní nemocnice Náchod 4
Published in the journal: Rozhl. Chir., 2019, roč. 98, č. 11, s. 434-440.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2019.98.11.434–440

Summary

Introduction: Analysis and comparison of short-term results of laparoscopic liver resections (LLR) and open liver resections (OLR) for colorectal cancer liver metastases (CRCLM).

Methods: Retrospective analysis of patients operated for CRCLM in the time period from May 2007 to May 2019 (12 years) at the department of surgery, University Hospital Hradec Králové and University Hospital Královské Vinohrady.

Results: 206 liver resections were performed; 167 (81.1%) OLR and 39 (18.9%) LLR procedures. Conversion to open surgery was necessary in 6 cases (15.4%). LLR was associated with a longer operation time (194±107 min) vs (129±58 min) for OLR. The ICU stay, 3.5±4.3 days for OLR and 4.1±8.1 days for LLR, and the hospital stay, 11.9±8.3 days (OLR) vs 12.1±11.3 days (LLR), were comparable. Perioperative blood loss was lower in the LLR group, 189±166 ml vs 360±410 ml. Total transfusion rate was similar, 10.8% (OLR) vs 12.8% (LLR). Oncologic radicality was also comparable in both groups; negative resection margin was achieved in 78% (OLR) and 80% (LLR). Postoperative morbidity and mortality was comparable in both groups; morbidity was 33% (OLR) vs 31% (LLR), while mortality was 1.8% (OLR) vs 2.6% (LLR).

Conclusion: LLR for CRCLM provided comparable short-term results compared to OLR in our group of patients even in the learning curve period. However, it should be noted that the study group is a highly selected group of patients.

Keywords:

liver resection – colorectal cancer – liver – metastases


Zdroje
  1. Azagra JS, Goergen M, Gilbart E, et al. Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc. 1996;10:758–61.
  2. Huscher CG, Lirici MM, Chiodini S. Laparoscopic liver resections. Semin Laparosc Surg. 1998;5:204–10.
  3. Fong Y, Jarnagin W, Conlon KC, et al. Hand-assisted laparoscopic liver resection: lessons from an initial experience. Arch Surg. 2000;135:854–59.
  4. Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement 2008. Ann Surg. 2009;250:825–30. doi:10.1097/sla.0b013e3181b3b2d8.
  5. Ciria R, Cherqui D, Geller DA, et al. Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg. 2016;263:761–77. doi:10.1097/SLA.0000000000001413.
  6. Wakabayashi G. What has changed after the Morioka consensus conference 2014 on laparoscopic liver resection? Hepatobiliary Surg Nutr. 2016;5:281–89. doi:10.21037/hbsn.2016.03.03.
  7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13. doi:10.1097/01.sla.0000133083.54934.ae.
  8. Šubrt Z, Ferko A, Jon B, et al. Laparoskopické resekce jater – úspěchy a nezdary spojené se zavedením nové metody. Kazuistiky. Rozhl Chir. 2009;88:509–13.
  9. Brown KM, Geller DA. What is the learning curve for laparoscopic major hepatectomy? J Gastrointest Surg. 2016;20:1065–71. doi:10.1007/s11605-016-3100-8.
  10. Ciria R, Ocaña S, Gomez-Luque I, et al. A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for liver metastases from colorectal cancer. Surg Endosc. 2019. [Epub ahead of print]. doi:10.1007/s00464-019-06774-2.
  11. Xie SM, Xiong JJ, Liu XT, et al. Laparoscopic versus open liver resection for colorectal liver metastases: A comprehensive systematic review and meta-analysis. Sci Rep. 2017;7:1012. doi:10.1038/s41598-017-00978-z.
  12. Cipriani F, Rawashden M, Stanton L, et al. Propensity score-based analysis of outcomes of laparoscopic versus open liver resection for colorectal metastases. Br J Surg. 2016; 103:1504–12. doi:10.1001/bjs.10211.
  13. Ratti F., Fiorentini G., Cipriani F, et al. Laparoscopic vs open surgery for colorectal liver metastases. JAMA Surg. 2018;153:1028–35. doi:10.1001/jamasurg.2018.2107.
  14. Fretland AA, Dagenborg VJ, Bjornelv GMW, et al. Laparoscopic versus open resection for colorectal liver metastases: The OSLO-COMET Randomized Controlled Trial. Ann Surg. 2018;267:199–207. doi:10.1080/08941939.2017.1385664.
  15. Aghayan DL, Fretland AA, Kazaryan AM, et al. Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial. HPB (Oxford) 2019. [Epub ahead of print]. doi:10.1016/j.hpb.2019.03.358.
  16. Goumard C, Farges O, Laurent A, et al. An update on laparoscopic liver resection: The French Hepato-Bilio-Pancreatic Surgery Association statement. J Visc Surg. 2015;152:107–12. doi:10.1016/j.jviscsurg.2015.02.003.
  17. Welsh FK, Tekkis PP, John TG, et al. Open liver resection for colorectal metastases: better short- and long-term outcomes in patients potentially suitable for laparoscopic liver resection. HPB (Oxford) 2010;12:188–94. doi:10.1111/j.1477-2574.2009.00143.x.
  18. Ban D, Tanabe M, Ito H, et al. A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci. 2014;21:745–53. doi:10.1002/jhbp.166.
  19. Ferko A, Vojtko M, Adamik M, et al. Totally laparoscopic ALPPS: bilobar procedure with preservation of the S3 portobiliary triad. Ann Surg Oncol. 2019;26:291. doi:10.1245/s10434-018-6930-7.
  20. Machado MA, Makdissi FF, Surjan RC, et al. Transition from open to laparoscopic ALPPS for patients with very small FLR: the initial experience. HPB (Oxford) 2017;19:59–66. doi:10.1016/j.hpb.2016.10.004.
  21. Liu R, Wakabayashi G, Kim HJ, et al. International consensus statement on robotic hepatectomy surgery in 2018. World J Gastroenterol. 2019;25:1432–44. doi:10.3748/wjg.v25.i12.1432.
  22. Sucandy I, Schlosser S, Bourdeau T, et al. Robotic hepatectomy for benign and malignant liver tumors. J Robot Surg. 2019. [Epub ahead of print]. doi:10.1007/s11701-019-00935-0.
Štítky
Surgery Orthopaedics Trauma surgery
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