Laparoscopic Versus Open Parenchymal Sparing Liver Surgery for Colorectal Liver Metastasis - a single center comparative study

Abstract

margin. R1 resection are defined if resection margin is less than 1mm. We used pathology report as a "gold standard" for estimation of intraoperative assessment but kappa and Mc Nemar test also used for statistical analysis of agreement. Results: There were included 80 patients,44(55%) male and 36(45%) women in the study 60.4AE9.50 years was average age. Primary tumour was located in 68 (85%) cases on left side of colon. We analyzed 208 liver specimens. In 155 (74.5%) cases there were agreement between surgical and pathological assessment clear margins (R0), in 16 (20.0%) cases both of them decided that it was R1 and 3 (1.44%) times R2 resection margins (positive margins). In 34 (16.3%) cases were disagreement because 25 (12.0%) times surgeon thought that margin was R0, and pathologist found R1, 8 (3.8%) times surgeon thought that was R1, and pathologist found that is R0, and 1 (0.5%) time surgeon's R2 was pathological R1. From this Results we concluded that intra-operative assessment of resection margin had sensitivity 45.65 % and specificity 95.06%. Positive predictive value was 74.2% and negative predictive value was 86.0%. Kappa K=0.466. There were significantly more positive margin by pathology examination 46 (22.1%) vs 29 (13.9%), p=0.008. Conclusion:Our Results suggest that intra-operative assessment resection margin have moderate agreement with pathological assessment as "gold standard". Pathology examination detect significantly more postitive resection margin.