Ann Hepatobiliary Pancreat Surg.  2018 Aug;22(3):223-230. 10.14701/ahbps.2018.22.3.223.

Outcomes of liver resection in patients with colorectal liver metastases by laparoscopic or open surgery

• Shim JR
• Lee SD
• Park HM
• Lee EC
• Park B
• Han SS
• Kim SH
• Park SJ

• KMID: 2420611
• DOI: http://doi.org/10.14701/ahbps.2018.22.3.223

Abstract

BACKGROUNDS/AIMS
Colorectal cancer is found with liver metastases about 20-25% due to characteristics of cancer itself. Approximately 20% of liver metastases are found to be resectable. The objective of this study was to evaluate short-term outcomes of patients who received liver resection with colorectal cancer operation in our center by laparoscopic surgery or open surgery.
METHODS
Short-term outcomes of laparoscopic surgery of liver resection (LSLR) group who underwent liver resection for colorectal liver metastases (CRLM) at a single institute from 2013 to 2016 were compared to those of open surgery of liver resection (OSLR) group.
RESULTS
A total of 123 patients underwent liver resection for CRLM, including 101 (82.1%) patients in the OSLR group and 22 (17.9%) patients in the LSLR group. There were significant differences in tumor characteristics between the two groups, including synchronous and metachronous (p=0.004), tumor number (p < 0.001), and tumor margin (p=0.002). For postoperative outcomes, only the length of hospital stay (LOS) was significantly different between the two groups (8.5 days in LSLR vs. 11 days in OSLR, p < 0.001). There was no significant difference in overall rate of postoperative complications between the two groups (9.1% in LSLR vs. 23.8% in OSLR, p=0.158).
CONCLUSIONS
There are no significant differences in postoperative outcomes between LSLR and OSLR except LOS, liver metastasis number, and resection margin. LSLR may be favorable for highly selected patients with CRLM.

Keyword

Colorectal liver metastasis; Laparoscopic surgery; Open surgery; Liver resection

MeSH Terms

Colorectal Neoplasms
Humans
Laparoscopy
Length of Stay
Liver*
Neoplasm Metastasis*
Postoperative Complications

Reference

1. Oh CM, Won YJ, Jung KW, Kong HJ, Cho H, Lee JK, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2013. Cancer Res Treat. 2016; 48:436–450. PMID: 26987395.

2. Leporrier J, Maurel J, Chiche L, Bara S, Segol P, Launoy G. A population-based study of the incidence, management and prognosis of hepatic metastases from colorectal cancer. Br J Surg. 2006; 93:465–474. PMID: 16523446.

3. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013; 63:11–30. PMID: 23335087.

4. Tanaka K, Shimada H, Matsuo K, Nagano Y, Endo I, Sekido H, et al. Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery. 2004; 136:650–659. PMID: 15349115.

5. de Santibañes E, Fernandez D, Vaccaro C, Quintana GO, Bonadeo F, Pekolj J, et al. Short-term and long-term outcomes after simultaneous resection of colorectal malignancies and synchronous liver metastases. World J Surg. 2010; 34:2133–2140. PMID: 20532766.

6. Litvak DA, Wood TF, Tsioulias GJ, Chung M, Chawla SP, Foshag LJ, et al. Systemic irinotecan and regional floxuridine after hepatic cytoreduction in 185 patients with unresectable colorectal cancer metastases. Ann Surg Oncol. 2002; 9:148–155. PMID: 11888871.

7. Karoui M, Penna C, Amin-Hashem M, Mitry E, Benoist S, Franc B, et al. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006; 243:1–7. PMID: 16371728.

8. Azagra JS, Goergen M, Gilbart E, Jacobs D. Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc. 1996; 10:758–761. PMID: 8662435.

9. Tzanis D, Shivathirthan N, Laurent A, Abu Hilal M, Soubrane O, Kazaryan AM, et al. European experience of laparoscopic major hepatectomy. J Hepatobiliary Pancreat Sci. 2013; 20:120–124. PMID: 23053354.

10. Dagher I, Di Giuro G, Dubrez J, Lainas P, Smadja C, Franco D. Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg. 2009; 198:173–177. PMID: 19268902.

11. Pearce NW, Di Fabio F, Teng MJ, Syed S, Primrose JN, Abu Hilal M. Laparoscopic right hepatectomy: a challenging, but feasible, safe and efficient procedure. Am J Surg. 2011; 202:e52–e58. PMID: 21861979.

12. Han HS, Cho JY, Yoon YS, Hwang DW, Kim YK, Shin HK, et al. Total laparoscopic living donor right hepatectomy. Surg Endosc. 2015; 29:184. PMID: 24993170.

13. Suh SW, Lee KW, Lee JM, Choi Y, Yi NJ, Suh KS. Clinical outcomes of and patient satisfaction with different incision methods for donor hepatectomy in living donor liver transplantation. Liver Transpl. 2015; 21:72–78. PMID: 25348280.

14. Bolton JS, Fuhrman GM. Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. Ann Surg. 2000; 231:743–751. PMID: 10767796.

15. Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, et al. Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol. 2007; 14:3481–3491. PMID: 17805933.

16. Muangkaew P, Cho JY, Han HS, Yoon YS, Choi Y, Jang JY, et al. Outcomes of simultaneous major liver resection and colorectal surgery for colorectal liver metastases. J Gastrointest Surg. 2016; 20:554–563. PMID: 26471363.

17. Silberhumer GR, Paty PB, Temple LK, Araujo RL, Denton B, Gonen M, et al. Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure. Am J Surg. 2015; 209:935–942. PMID: 25601556.

18. Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B. Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg. 2009; 250:849–855. PMID: 19801934.

19. Kazaryan AM, Marangos IP, Røsok BI, Rosseland AR, Villanger O, Fosse E, et al. Laparoscopic resection of colorectal liver metastases: surgical and long-term oncologic outcome. Ann Surg. 2010; 252:1005–1012. PMID: 21107111.

20. Inoue Y, Hayashi M, Tanaka R, Komeda K, Hirokawa F, Uchiyama K. Short-term results of laparoscopic versus open liver resection for liver metastasis from colorectal cancer: a comparative study. Am Surg. 2013; 79:495–501. PMID: 23635585.