Laparoscopic liver resection in the treatment of colorectal liver metastasis. Comparative study with the open approach

Abstract

Background: since the first laparoscopic liver resection (LLR) in 1992, many international groups have tried to show the feasibility and safety of this technique. Nevertheless, there is no randomized clinical trial that compares their results with the open approach.
Objective: to analyse the results of LLR, comparing them with a similar group of patients approached in the open way for the treatment of colorectal liver metastasis (CRLM).
Material and methods: retrospective analysis. We included all patients with diagnosis of CRLM resected between July 2007 and July 2015 that were considered as “laparoscopically feasible”.
Results: twenty-two open resections and 18 LLR were analyzed. The time of surgery was shorter in the laparoscopic group (248.8 vs. 305.4min), being this the only operative variable with a difference statistically significant.
Postoperative morbidity for open and LLR was 44% and 38%, respectively, not being this difference significant.
The disease free survival at 1, 3 and 5 years for the LLR (n = 16) were 77%, 51% and 51%, while in the open group (n = 18), it was 62%, 35% and 26% respectively, with a mean follow up of 32 months, not being this difference statistically significant.
Conclusion: LLR in patients with CRLM, in segments considered as “laparoscopically feasible”, had similar morbidity as with the open approach with good oncological margins. This could allow for the laparoscopic approach to be indicated in this group of patients.