Laparoscopic Versus Open Liver Resection for Colorectal Metastases in Elderly and Octogenarian Patients

Martínez‐Cecilia, David; Cipriani, Federica; Shelat, Vishal G; Ratti, Francesca; Tranchart, Hadrien; Barkhatov, Leonid; Tomassini, Federico; Montalti, Roberto; Halls, Mark; Troisi, Roberto; Dagher, Ibrahim; Aldrighetti, Luca; Edwin, Bjørn; Hilal, Mohammed Abu

doi:10.1097/sla.0000000000002147

Cited by 126 publications

(108 citation statements)

References 48 publications

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“…Literature review revealed three other studies performed on liver resection in octogenarians, plus one study with a subset of octogenarians . Martínez‐Cecilia et al .…”

Section: Discussionmentioning

confidence: 99%

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Liver resection in octogenarians: are the outcomes worth the risk?

Gupta

Kanhere

Maddern

et al. 2018

ANZ Journal of Surgery

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“…Literature review revealed three other studies performed on liver resection in octogenarians, plus one study with a subset of octogenarians . Martínez‐Cecilia et al .…”

Section: Discussionmentioning

confidence: 99%

“…Short‐term and perioperative outcomes from liver resection in octogenarians have been determined previously . Riffat et al .…”

Section: Introductionmentioning

confidence: 99%

Liver resection in octogenarians: are the outcomes worth the risk?

Gupta

Kanhere

Maddern

et al. 2018

ANZ Journal of Surgery

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“…The mortality in these cases was not really due to age, but rather comorbidities and PLA complications in patients with comorbidities; these factors were more important than age alone. Recently, Martínez-Cecilia et al reported that octogenarians have comparable outcomes to younger people in colorectal liver metastases when treated with laparoscopic liver resection [36]. Thus, comorbidity and complications are more important prognostic factors than age.…”

Section: Discussionmentioning

confidence: 99%

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

et al. 2017

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BackgroundTo analyse the clinical, epidemiological, microbiological and prognostic differences of pyogenic liver abscess (PLA) in older (≥ 65 years of age) versus younger patients (< 65 years).MethodsMulticentre, retrospective cohort study in all patients with PLA admitted to two Spanish hospitals from January 2000 to January 2014. Cases were divided into two age groups (< 65 years and ≥65 years) for comparison of clinical, epidemiological and microbiological characteristics as well as treatment.ResultsOf 98 patients analysed, 40 patients were younger than 65, and 58 were aged 65 or older. Significant associations in the older group were found with female sex (adjusted odds ratio [ORa] 9.0; 95% CI 1.4, 56), non-cryptogenic origin (ORa 14.5; 95% CI 1.6, 129), absence of chronic liver disease (ORa 14; 95% CI 1.3, 155), Escherichia coli infection (ORa 7.7; 95% CI 1.03, 58), and incidence of complications (ORa 2.3; 95% CI 1.04, 5.4). Mortality was 8.2% overall, although all deaths occurred in the older group (8/58; 13.8%) (p = 0.02).DiscussionOur results are in consonance with other published studies. Older patients with PLA tend to present more anomalies in the biliary tract (Kai et. al, World J Gastroenterol 18: 2948-295, 2012, Rahimian et. al, Clin Infect Dis 39:1654-9, 2004, Seeto, Medicine (Baltimore) 75:99-113, 1996, Kao et.al, Aliment Pharmacol Ther 36:467-76, 2012, Lai et. al, Gastroenterology 146:129-37, 2014), while younger patients are more often male and present more commonly with previous liver disease (especially related to alcohol) and cryptogenic PLA.ConclusionIn patients aged 65 or older, PLA was more common in women and in those with a history of biliary disease, and E. coli was the most frequent bacterium. Mortality was also higher in the older group.

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“…Laparotomy has long been the preferred surgical approach but laparoscopic liver resection (LLR) is gaining popularity. Advantages of LLR include a quicker recovery and reduced morbidity leading to the consensus that laparoscopy should be considered the standard approach to minor liver resections. However, repeat liver resection is considered a challenging procedure owing to adhesions, anatomical distortion caused by the previous liver resection and other treatment modalities that are often used in the setting of recurrent disease.…”

Section: Introductionmentioning

confidence: 99%

Multicentre propensity score-matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases

Poel

Barkhatov

Fuks

et al. 2019

British Journal of Surgery

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Background: Repeat liver resection is often the best treatment option for patients with recurrent colorectal liver metastases (CRLM). Repeat resections can be complex, however, owing to adhesions and altered liver anatomy. It remains uncertain whether the advantages of a laparoscopic approach are upheld in this setting. The aim of this retrospective, propensity score-matched study was to compare the short-term outcome of laparoscopic (LRLR) and open (ORLR) repeat liver resection.Methods: A multicentre retrospective propensity score-matched study was performed including all patients who underwent LRLRs and ORLRs for CRLM performed in nine high-volume centres from seven European countries between 2000 and 2016. Patients were matched based on propensity scores in a 1 : 1 ratio. Propensity scores were calculated based on 12 preoperative variables, including the approach to, and extent of, the previous liver resection. Operative outcomes were compared using paired tests. Results: Overall, 425 repeat liver resections were included. Of 271 LRLRs, 105 were matched with an ORLR. Baseline characteristics were comparable after matching. LRLR was associated with a shorter duration of operation (median 200 (i.q.r. 123-273) versus 256 (199-320) min; P < 0⋅001), less intraoperative blood loss (200 (50-450) versus 300 (100-600) ml; P = 0⋅077) and a shorter postoperative hospital stay (5 (3-8) versus 6 (5-8) days; P = 0⋅028). Postoperative morbidity and mortality rates were similar after LRLR and ORLR. Conclusion: LRLR for CRLM is feasible in selected patients and may offer advantages over an open approach.

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Laparoscopic Versus Open Liver Resection for Colorectal Metastases in Elderly and Octogenarian Patients

Cited by 126 publications

References 48 publications

Liver resection in octogenarians: are the outcomes worth the risk?

Liver resection in octogenarians: are the outcomes worth the risk?

Clinical and epidemiological characteristics of pyogenic liver abscess in people 65 years or older versus people under 65: a retrospective study

Multicentre propensity score-matched study of laparoscopic versus open repeat liver resection for colorectal liver metastases

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