Background. This study is to evaluate overall results of liver surgery for colorectal liver metastases (CRLM) by comparing the open approach (OS) with the laparoscopic (LS) in a case-control matched pair analysis. Methods. Between January 2005 and September 2009 a total 533 liver resections were performed in our institution. During this period laparoscopic liver resection of CRLM was increasingly performed in 40 cases. Data from the LS group were compared with those obtained from a control group undergoing open surgery for a similar indication in a matched-pair analysis. Pairs were matched as closely as possible for age and gender, type of resection, location of the tumoral lesions and surgery date. Endpoints were: overall morbidity, R0 resection rates, recurrence rates and hospital stay. Results. The median follow-up was of 15.6 m for LS and 23.4 for OS (p=0.02). The median age was of 69 y in the LS group and 23.4 in OS. Conversion to laparotomy was required in 3(7.5%) out of 40 laparoscopic cases due to uncontrolled bleeding. In both groups 8(20%) major and 32(80%) minor hepatectomies were performed. The overall morbidity in the LS group was 0.5% (2/40) and 3% (11/40) respectively in LS and OS groups. Similar R0 resection rates were found between LS and OS groups: 35/40(87.5%) cases vs. 32/40 (80%) cases respectively. The recurrence rate was of 15% (6/40) in the LS group and 40% (16/40) in the OS group respectively (p=0.02). The median hospital stay was shorter in the LS group: 7 days (P=0.01). Conclusions. According to this experience, laparoscopic resection of colorectal liver metastases can be considered as a good even preferable alternative when possible to open surgery. Mid-term oncological outcomes are similar, being the overall morbidity and hospital stay significantly less in the laparoscopic approach.

LAPAROSCOPIC RESECTION OF COLORECTAL LIVER METASTASES: A SINGLE CENTER CASE-CONTROL MATCHED-PAIRS ANALYSIS / Montalti, R; Van den Bossche, B; Cavaniglia, D; Castagnola, G; Laurent, S; Geboes, K; de Hemptinne, B; Troisi, Roberto. - (2012). (Intervento presentato al convegno 10th World Congress of the International Hepato-Pancreato-Biliary Association. tenutosi a Paris, France. nel July 1-5, 2012.).

LAPAROSCOPIC RESECTION OF COLORECTAL LIVER METASTASES: A SINGLE CENTER CASE-CONTROL MATCHED-PAIRS ANALYSIS.

Montalti R
;
Troisi Roberto
Ultimo
Supervision
2012

Abstract

Background. This study is to evaluate overall results of liver surgery for colorectal liver metastases (CRLM) by comparing the open approach (OS) with the laparoscopic (LS) in a case-control matched pair analysis. Methods. Between January 2005 and September 2009 a total 533 liver resections were performed in our institution. During this period laparoscopic liver resection of CRLM was increasingly performed in 40 cases. Data from the LS group were compared with those obtained from a control group undergoing open surgery for a similar indication in a matched-pair analysis. Pairs were matched as closely as possible for age and gender, type of resection, location of the tumoral lesions and surgery date. Endpoints were: overall morbidity, R0 resection rates, recurrence rates and hospital stay. Results. The median follow-up was of 15.6 m for LS and 23.4 for OS (p=0.02). The median age was of 69 y in the LS group and 23.4 in OS. Conversion to laparotomy was required in 3(7.5%) out of 40 laparoscopic cases due to uncontrolled bleeding. In both groups 8(20%) major and 32(80%) minor hepatectomies were performed. The overall morbidity in the LS group was 0.5% (2/40) and 3% (11/40) respectively in LS and OS groups. Similar R0 resection rates were found between LS and OS groups: 35/40(87.5%) cases vs. 32/40 (80%) cases respectively. The recurrence rate was of 15% (6/40) in the LS group and 40% (16/40) in the OS group respectively (p=0.02). The median hospital stay was shorter in the LS group: 7 days (P=0.01). Conclusions. According to this experience, laparoscopic resection of colorectal liver metastases can be considered as a good even preferable alternative when possible to open surgery. Mid-term oncological outcomes are similar, being the overall morbidity and hospital stay significantly less in the laparoscopic approach.
2012
LAPAROSCOPIC RESECTION OF COLORECTAL LIVER METASTASES: A SINGLE CENTER CASE-CONTROL MATCHED-PAIRS ANALYSIS / Montalti, R; Van den Bossche, B; Cavaniglia, D; Castagnola, G; Laurent, S; Geboes, K; de Hemptinne, B; Troisi, Roberto. - (2012). (Intervento presentato al convegno 10th World Congress of the International Hepato-Pancreato-Biliary Association. tenutosi a Paris, France. nel July 1-5, 2012.).
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/759579
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