Laparoscopic versus open resection of hepatic colorectal metastases

Background This study was undertaken to assess the safety and efficacy of laparoscopic versus open resection of hepatic colorectal metastases (CRM). Methods We reviewed retrospectively of all patients undergoing initial resection of CRM at a single institution between 1995 and 2010. The study cohort...

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Bibliographic Details
Published in:Surgery 2012-10, Vol.152 (4), p.567-574
Main Authors: Cannon, Robert M., MD, Scoggins, Charles R., MD, MBA, Callender, Glenda G., MD, McMasters, Kelly M., MD, PhD, Martin, Robert C.G., MD, PhD
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Cohort Studies
Colorectal Neoplasms
Disease-Free Survival
General aspects
Hepatectomy - methods
Humans
Kaplan-Meier Estimate
Laparoscopy - methods
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Medical sciences
Middle Aged
Retrospective Studies
Surgery
Treatment Outcome
Tumors
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Summary:Background This study was undertaken to assess the safety and efficacy of laparoscopic versus open resection of hepatic colorectal metastases (CRM). Methods We reviewed retrospectively of all patients undergoing initial resection of CRM at a single institution between 1995 and 2010. The study cohort consisted of all patients undergoing laparoscopic resection and a cohort of patients undergoing open resection matched on a 4:1 basis by propensity scoring. Variables analyzed included patient and tumor characteristics, short-term outcomes, and OS and disease-free (DFS) survivals. Results The 35 patients in the laparoscopic cohort and 140 patients in the open cohort were equivalent in terms of age, Charlson Comorbidity Index, tumor characteristics, and Clinical Risk Score. Similar proportions of patients in the laparoscopic and open groups underwent synchronous colectomy (9% in both; P = .976) and major hepatectomy (54% vs 51%; P = .705). Blood loss (202 vs 385 mL; P < .001), complications (23% vs 50%; P = .004), and duration of stay (4.8 vs 8.3 days; P < .001) were less in the laparoscopic cohort. Five-year OS (36% vs 42%; P = .818) and DFS (15% vs 22%; P  = .346) were also similar in the laparoscopic and open groups. Conclusion Laparoscopic resection of hepatic CRM seems to be a beneficial alternative to open surgery in appropriately selected patients.
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2012.07.013