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