Jianguo Qiu1, Shuting Chen, Prasoon Pankaj, Hong Wu. 1. *Department of Hepatobiliary Surgery, The First Affiliated Hospital, Chongqing Medical University, Chongqing †Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Abstract
BACKGROUND: Laparoscopic hepatectomy (LH) provides significant promising results when compared with open hepatectomy (OH). However, the oncologic outcome of LH for hepatic colorectal metastases (HCRM) remains controversial. The purpose of this study was to review the results of LH retrospectively and to compare them with those obtained using the conventional OH procedure for HCRM patients. MATERIALS AND METHODS: Demographic details of 24 patients with pathologic determination of HCRM who underwent LH were reviewed retrospectively and weighed against the 25 HCRM patients chosen from the prospective OH database. Postsurgical benefits and 3-year outcomes of these 2 groups were compared. RESULTS: The LH had a significantly less estimated blood loss (210 vs. 380 mL; P<0.01), less analgesic requirements (20.8% vs. 50.2%; P<0.001), shorter hospital stay (7.4 vs. 11.4 d; P<0.0001), and less postoperative complication rates (25% vs. 48%; P=0.02) compared with the OH approach. The operative time, positive surgical margin, and postoperative liver function changes were similar in the 2 groups. There were no significant differences between the 2 groups in tumor recurrence and the 3-year overall survival rate (24% vs. 30%; P=0.83), respectively. CONCLUSIONS: LH is a practicable replacement for OH with probable advantages within the short-term outcomes for elected HCRM patients. Nevertheless, it remains an approach in advancement; in addition, randomized controlled trails and prolonged follow-up are necessary to verify its oncologic benefits and long-term survival.
BACKGROUND: Laparoscopic hepatectomy (LH) provides significant promising results when compared with open hepatectomy (OH). However, the oncologic outcome of LH for hepatic colorectal metastases (HCRM) remains controversial. The purpose of this study was to review the results of LH retrospectively and to compare them with those obtained using the conventional OH procedure for HCRM patients. MATERIALS AND METHODS: Demographic details of 24 patients with pathologic determination of HCRM who underwent LH were reviewed retrospectively and weighed against the 25 HCRM patients chosen from the prospective OH database. Postsurgical benefits and 3-year outcomes of these 2 groups were compared. RESULTS: The LH had a significantly less estimated blood loss (210 vs. 380 mL; P<0.01), less analgesic requirements (20.8% vs. 50.2%; P<0.001), shorter hospital stay (7.4 vs. 11.4 d; P<0.0001), and less postoperative complication rates (25% vs. 48%; P=0.02) compared with the OH approach. The operative time, positive surgical margin, and postoperative liver function changes were similar in the 2 groups. There were no significant differences between the 2 groups in tumor recurrence and the 3-year overall survival rate (24% vs. 30%; P=0.83), respectively. CONCLUSIONS:LH is a practicable replacement for OH with probable advantages within the short-term outcomes for elected HCRM patients. Nevertheless, it remains an approach in advancement; in addition, randomized controlled trails and prolonged follow-up are necessary to verify its oncologic benefits and long-term survival.
Authors: Ahmad Ozair; Amelia Collings; Alexandra M Adams; Rebecca Dirks; Bradley S Kushner; Iswanto Sucandy; David Morrell; Ahmed M Abou-Setta; Timothy Vreeland; Jake Whiteside; Jordan M Cloyd; Mohammed T Ansari; Sean P Cleary; Eugene Ceppa; William Richardson; Adnan Alseidi; Ziad Awad; Subhashini Ayloo; Joseph F Buell; Georgios Orthopoulos; Samer Sbayi; Go Wakabayashi; Bethany J Slater; Aurora Pryor; D Rohan Jeyarajah Journal: Surg Endosc Date: 2022-09-22 Impact factor: 3.453