Laparoscopic liver resection compared to open approach in patients with colorectal liver metastases improves further resecability: Oncological outcomes of a case-control matched-pairs analysis

Introduction: 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. Method: 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-year overall survival rate was 65% and 60% respectively (p = 0.36) and the 5-year 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 loss, morbidity rate and hospital stay. It provides comparable longterm oncological outcomes but can improve further resecability in patients with recurrent disease.