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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2019

01-12-2019 | Metastasis

Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial

Authors: Ricardo Robles-Campos, Víctor Lopez-Lopez, Roberto Brusadin, Asunción Lopez-Conesa, Pedro José Gil-Vazquez, Álvaro Navarro-Barrios, Pascual Parrilla

Published in: Surgical Endoscopy | Issue 12/2019

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Abstract

Objective

To present surgical and oncological outcomes using a prospective and randomized trial (LapOpHuva, NCT02727179) comparing minimally invasive liver resection (LLR) versus open liver resection (OLR) in patients with colorectal liver metastases (CRLM).

Methods

Between February 2005 and March 2016, 204 selected patients with CRLM were randomized and 193 were included: LLR (n = 96) and OLR (n = 97). The primary endpoint was to compare postoperative morbidity. Other secondary endpoints were oncological outcomes, use of the Pringle maneuver, surgical time, blood losses, transfusions, hospital stay, mortality and OS, and disease-free survival (DFS) at 3, 5, and 7 years.

Results

LLR presented with lower global morbidity (11.5% vs. 23.7%, p = 0.025) but with similar severe complications. Long-term survival outcomes were similar in both groups. The cumulative 1-, 3-, 5-, 7-year OS for LLR and OLR were 92.5%, 71.5%, 49.3%, 35.6% versus 93.6%, 69.7%, 47.4%, 35.5%, respectively (log-rank = 0.047, p = 0.82). DFS for LLR and OLR was 72.7%, 33.5%, 22.7%, and 20.8% versus 61.6%, 27.2%, 23.9%, and 17.9%, respectively (log-rank = 1.427, p = 0.23). LLR involved more use of the Pringle maneuver (15.5% vs. 30.2%, p = 0.025) and a shorter hospital stay (4 vs. 6 days, p < 0.001). There were no differences regarding surgical time, blood losses, transfusion, and mortality.

Conclusions

In selected patients with CRLM, LLR presents similar oncological outcomes with the advantages of the short-term results associated with LLR.
Appendix
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Metadata
Title
Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial
Authors
Ricardo Robles-Campos
Víctor Lopez-Lopez
Roberto Brusadin
Asunción Lopez-Conesa
Pedro José Gil-Vazquez
Álvaro Navarro-Barrios
Pascual Parrilla
Publication date
01-12-2019
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 12/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-06679-0

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