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01-06-2015 | Original Article

Oncological safety of ultrasound-guided laparoscopic liver resection for colorectal metastases: a case–control study

Authors: Serena Langella, Nadia Russolillo, Marco D’Eletto, Fabio Forchino, Roberto Lo Tesoriere, Alessandro Ferrero

Published in: Updates in Surgery | Issue 2/2015

Abstract

Laparoscopic liver surgery has gained widespread acceptance and nowadays it is suggested even for malignant disease. Although the benefits on short-term outcomes have been proven, data on oncological safety are still lacking. The aim of this study is to assess oncologic results after ultrasound-guided laparoscopic liver resection (LLR) or open liver resection (OLR) for colorectal metastases. 37 consecutive patients undergoing LLR between 01/2004 and 03/2014 were matched at a ratio of 1:1 with 37 OLR. Matching criteria were male sex, number and diameter of liver metastases, segment location, synchronous presentation, site and stage of primary tumor, positive lymph nodes of the primary, and concomitant extrahepatic disease. Demographic characteristics were similar among groups. Parenchymal transection time was longer in the LLR group (68 ± 38.2 SD vs 40 ± 33.7 SD, p = 0.01). Mortality was nil in LLR and OLR. Overall morbidity was significantly lower in LLR (13.5 vs 37.8 %, p = 0.02), although severe complications were similar among the two groups. Patients undergoing LLR were discharged earlier (5 ± 2.3 SD vs 8 ± 6.6 SD days, p < 0.001). The median margin width was 5 (0–40) mm in LLR vs 8 (0–25) mm in OLR, p = 0.897. R1 resection was recorded in four LLR and three OLR (p = 1). Overall recurrences were similar among groups. Eight patients with hepatic or extrahepatic recurrence among LLR underwent surgery vs four of OLR (p = 0.03). After a median follow-up of 35.7 months in LLR and 47.9 months in OLR, 3-year overall survival was 91.8 % LLR and 74.8 % OLR (p = 0.14). 3-year disease-free survival was 69.1 % LLR and 65.9 % OLR (p = 0.53). Multivariate analysis showed that postoperative complications [HR 3.42 (95 % CI 1.32–8.89)] and multiple metastases [HR 3.84 (95 % CI 1.34–10.83)] were independent predictors of worse survival (p = 0.01). Ultrasound-LLR for colorectal hepatic metastases is safe, ensuring oncologic outcomes comparable to OLR.

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Title: Oncological safety of ultrasound-guided laparoscopic liver resection for colorectal metastases: a case–control study
Authors: Serena Langella
Nadia Russolillo
Marco D’Eletto
Fabio Forchino
Roberto Lo Tesoriere
Alessandro Ferrero
Publication date: 01-06-2015
Publisher: Springer Milan
Published in: Updates in Surgery / Issue 2/2015
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-015-0325-0

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Oncological safety of ultrasound-guided laparoscopic liver resection for colorectal metastases: a case–control study

Abstract

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Springer Medicine

Abstract

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