Short-term results of laparoscopic versus open liver resection for liver metastasis from colorectal cancer: a comparative study

• Published in: The American surgeon 2013-05, Vol.79 (5), p.495-501
• Main Authors: Inoue, Yoshihiro, Hayashi, Michihiro, Tanaka, Ryo, Komeda, Koji, Hirokawa, Fumitoshi, Uchiyama, Kazuhisa
• Format: Article
• Language: English
• Subjects: Abdomen; Adult; Aged; Aged, 80 and over; Biomarkers - blood; Blood Loss, Surgical - statistics & numerical data; Colorectal Neoplasms - pathology; Female; Follow-Up Studies; Hepatectomy - methods; Hepatectomy - mortality; Hospitals; Humans; Hyperglycemia; Inflammation - blood; Inflammation - etiology; Laparoscopy - mortality; Length of Stay - statistics & numerical data; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Logistic Models; Male; Middle Aged; Mortality; Multivariate Analysis; Postoperative Complications - blood; Postoperative Complications - epidemiology; Proportional Hazards Models; Retrospective Studies; Surgery; Treatment Outcome; Tumors; Ultrasonic imaging
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/000313481307900525

Laparoscopic liver resection is currently performed in an increasing number of institutions as a minimally invasive treatment. However, no randomized controlled trials have compared laparoscopic and open liver resections. Twenty-three laparoscopic and 24 open liver resections for colorectal cancer liver metastases (CRCLM) were performed, and these data for both were retrospectively compared in the short-term results. The estimated blood loss was 99 ± 207 mL in the laparoscopic group and 397 ± 381 mL in the open group (P = 0.0018); blood loss was significantly higher in the open group. There were no differences in the surgical procedure, blood loss, transfusion rate, pathological margins, postoperative complications, 30-day mortality, duration of intravenous drip, or hospital stay. On postoperative courses, the values of total bilirubin, white blood cell count, and C-reactive protein were significantly lower in the laparoscopic group. The data of the present series suggest the lesser invasiveness and safety of laparoscopic liver resection even for patients with CRCLM, and they showed that postoperative laboratory tests were better after laparoscopy than after the traditional open approach with better short-term results. Tumor diameter less than 5 cm appears to be the appropriate indication for laparoscopic liver resection for CRCLM.