BACKGROUND: The purpose of this original article was to evaluate the impact of the Pringle maneuver on the survival of patients with colorectal liver metastases. METHODS:Eighty patients with colorectal liver metastases were randomized to undergo hepatectomywith (39 patients, HPC group) or without (41 patients, NHPC group) pedicle clamping. RESULTS: The two groups were homogeneous. Mortality and morbidity rates were similar. Blood transfusions rates were higher in HPC group (p = 0.010). Median follow-up was 67.1 +/- 20 months in the HPC group and 77.5 +/- 16.6 months in the other group (p = 0.07). Overall survival at 1, 3, and 5 years was 100%, 86.1%, and 49.4% in HPC group vs. 92.6%, 65.8%, and 48.2% in NHPC group (p = 0.704). Disease-free survival was similar between the two groups: 1-, 3- and 5-year survival rates were 85.7%, 51.4%, and 34.3% in the HPC group vs. 84%, 51.5%, and 37.9% in NHPC group (p = 0.943). The incidence of hepatic recurrence was similar in the two groups (p = 0.506). Median time to hepatic recurrence was similar in the two groups (p = 0.482). Overall and disease-free survival rates were similar even when the Pringle maneuver was longer than 45 min (p = 0.571 and 0.948) and in patients with liver steatosis (p = 0.779 and 0.412). CONCLUSIONS: The Pringle maneuver does not seem to affect the survival of patients with liver metastases.
RCT Entities:
BACKGROUND: The purpose of this original article was to evaluate the impact of the Pringle maneuver on the survival of patients with colorectal liver metastases. METHODS: Eighty patients with colorectal liver metastases were randomized to undergo hepatectomy with (39 patients, HPC group) or without (41 patients, NHPC group) pedicle clamping. RESULTS: The two groups were homogeneous. Mortality and morbidity rates were similar. Blood transfusions rates were higher in HPC group (p = 0.010). Median follow-up was 67.1 +/- 20 months in the HPC group and 77.5 +/- 16.6 months in the other group (p = 0.07). Overall survival at 1, 3, and 5 years was 100%, 86.1%, and 49.4% in HPC group vs. 92.6%, 65.8%, and 48.2% in NHPC group (p = 0.704). Disease-free survival was similar between the two groups: 1-, 3- and 5-year survival rates were 85.7%, 51.4%, and 34.3% in the HPC group vs. 84%, 51.5%, and 37.9% in NHPC group (p = 0.943). The incidence of hepatic recurrence was similar in the two groups (p = 0.506). Median time to hepatic recurrence was similar in the two groups (p = 0.482). Overall and disease-free survival rates were similar even when the Pringle maneuver was longer than 45 min (p = 0.571 and 0.948) and in patients with liver steatosis (p = 0.779 and 0.412). CONCLUSIONS: The Pringle maneuver does not seem to affect the survival of patients with liver metastases.
Authors: David A Kooby; Jennifer Stockman; Leah Ben-Porat; Mithat Gonen; William R Jarnagin; Ronald P Dematteo; Scott Tuorto; David Wuest; Leslie H Blumgart; Yuman Fong Journal: Ann Surg Date: 2003-06 Impact factor: 12.969
Authors: Melanie E Tsang; Paul J Karanicolas; Rogeh Habashi; Eva Cheng; Sherif S Hanna; Natalie G Coburn; Calvin H L Law; Julie Hallet Journal: HPB (Oxford) Date: 2015-09 Impact factor: 3.647
Authors: Kit Fai Lee; Charing C N Chong; Sunny Y S Cheung; John Wong; Andrew K Y Fung; Hon Ting Lok; Paul B S Lai Journal: World J Surg Date: 2019-12 Impact factor: 3.352