Abstract:The long-term oncologic outcome of surgically treated patients with CRLM is determined by the Fong's CRS. Although MILS does not influence long-term survival, it has a beneficial impact on the immediate postoperative clinical outcome.
“…Our analysis demonstrates that laparoscopic liver resection acquired lower postoperative morbidity than open liver resection. Similar finding is also reported by multiple observational studies, in which morbidity rate for laparoscopic liver resection varies from 11% to 15% [33–35] and for open liver resection varies from 22% to 47% [36, 37]. In terms of the other surgical outcomes, our analysis showed that colorectal liver metastases patients with laparoscopic liver resection acquired lower blood loss, less blood transfusion requirements and shorter hospitalization time than with open liver resection.…”
BackgroundTo compare surgical and oncological outcomes of laparoscopic versus open liver resection for colorectal liver metastases.ResultsA total of 14 retrospective studies with 1679 colorectal liver metastases patients were analyzed: 683 patients treated with laparoscopic liver resection and 996 patients with open liver resection. With respect to surgical outcomes, laparoscopic compared with open liver resection was associated with lower blood loss (MD, -216.7, 95% CI, -309.4 to -124.1; P < 0.00001), less requiring blood transfusion (OR, 0.36; 95% CI, 0.23 to 0.55; P < 0.00001), lower postoperative complication morbidity (OR, 0.61; 95% CI, 0.47 to 0.80; P = 0.003), and shorter hospitalization time (MD, -3.85, 95% CI, -5.00 to -2.71; P < 0.00001). However, operation time and postoperative mortality were no significant difference between the two approaches. With respect to oncological outcomes, laparoscopic liver resection group was prone to lower recurrence rate (OR, 0.78; 95% CI, 0.61−0.99; P = 0.04), but surgical margins R0, overall survival and disease-free survival were no significant difference.Materials and MethodsWe performed a systematic search in MEDLINE, EMBASE, and CENTRAL for all relevant studies. All statistical analysis was performed using Review Manager version 5.3. Dichotomous data were calculated by odds ratio (OR) and continuous data were calculated by mean difference (MD) with 95% confidence intervals (CI).ConclusionsLaparoscopic and open liver resection for colorectal liver metastases have the same effect on oncological outcomes, but laparoscopic liver resection achieves better surgical outcomes.
“…Our analysis demonstrates that laparoscopic liver resection acquired lower postoperative morbidity than open liver resection. Similar finding is also reported by multiple observational studies, in which morbidity rate for laparoscopic liver resection varies from 11% to 15% [33–35] and for open liver resection varies from 22% to 47% [36, 37]. In terms of the other surgical outcomes, our analysis showed that colorectal liver metastases patients with laparoscopic liver resection acquired lower blood loss, less blood transfusion requirements and shorter hospitalization time than with open liver resection.…”
BackgroundTo compare surgical and oncological outcomes of laparoscopic versus open liver resection for colorectal liver metastases.ResultsA total of 14 retrospective studies with 1679 colorectal liver metastases patients were analyzed: 683 patients treated with laparoscopic liver resection and 996 patients with open liver resection. With respect to surgical outcomes, laparoscopic compared with open liver resection was associated with lower blood loss (MD, -216.7, 95% CI, -309.4 to -124.1; P < 0.00001), less requiring blood transfusion (OR, 0.36; 95% CI, 0.23 to 0.55; P < 0.00001), lower postoperative complication morbidity (OR, 0.61; 95% CI, 0.47 to 0.80; P = 0.003), and shorter hospitalization time (MD, -3.85, 95% CI, -5.00 to -2.71; P < 0.00001). However, operation time and postoperative mortality were no significant difference between the two approaches. With respect to oncological outcomes, laparoscopic liver resection group was prone to lower recurrence rate (OR, 0.78; 95% CI, 0.61−0.99; P = 0.04), but surgical margins R0, overall survival and disease-free survival were no significant difference.Materials and MethodsWe performed a systematic search in MEDLINE, EMBASE, and CENTRAL for all relevant studies. All statistical analysis was performed using Review Manager version 5.3. Dichotomous data were calculated by odds ratio (OR) and continuous data were calculated by mean difference (MD) with 95% confidence intervals (CI).ConclusionsLaparoscopic and open liver resection for colorectal liver metastases have the same effect on oncological outcomes, but laparoscopic liver resection achieves better surgical outcomes.
“…Initial screening of abstracts led to the exclusion of 383 articles. Besides, six were further excluded by a close scrutiny of remaining articles: 1 35 only included OLR, 3 duplicates 24,36,37 , 1 38 did not report outcomes of interest and 1 39 used radiofrequency ablation. Finally, 32 non-randomized comparative studies were included in our meta-analysis 20,26,27,40–68 .Figure 1Study selection flow chart according to PRISMA statement.…”
The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary endpoints were oncological outcomes. In total, 32 eligible non-randomized studies with 4697 patients (LLR: 1809, OLR: 2888) were analyzed. There were higher rates of clear surgical margins (OR: 1.64, 95%CI: 1.32 to 2.05, p < 0.00001) in the LLR group, without significant differences in disease recurrence, 3- or 5-year overall survival(OS) and disease free survival(DFS) between the two approaches. LLR was associated with less intraoperative blood loss (WMD: −147.46 [−195.78 to −99.15] mL, P < 0.00001) and fewer blood transfusions (OR: 0.41 [0.30–0.58], P < 0.00001), but with longer operation time (WMD:14.44 [1.01 to 27.88] min, P < 0.00001) compared to OLR. Less overall morbidity (OR: 0.64 [0.55 to 0.75], p < 0.00001) and shorter postoperative hospital stay (WMD: −2.36 [−3.06 to −1.66] d, p < 0.00001) were observed for patients undergoing LLR, while there was no statistical difference in mortality. LLR appears to be a safe and feasible alternative to OLR in the treatment of CCLM in selected patients.
“…Liver resection is associated with significant mortality and morbidity, due to complications such as post hepatectomy liver failure, blood loss and bile leak, among other general complications. Post‐operative complications have a reported prevalence of 4‐53%, with morbidity for open liver resections ranging from 22‐47% as opposed to 11‐15% for laparoscopic resections . Asiyanbola et al conducted a review of literature based ( n > 7000) versus population based ( n > 11 000) mortality rates and found a lower reported mortality rate in publications (2.6%) verses national statistics (4.9%) …”
Section: Introductionmentioning
confidence: 99%
“…Postoperative complications have a reported prevalence of 4-53%, [5][6][7][8] with morbidity for open liver resections ranging from 22-47% as opposed to 11-15% for laparoscopic resections. [9][10][11][12][13] Asiyanbola et al conducted a review of literature based (n > 7000) versus population based (n > 11 000) mortality rates and found a lower reported mortality rate in publications (2.6%) verses national statistics (4.9%). 14 Currently, strategies to detect post-operative complications following liver resection include clinical examination, post-operative drain monitoring, hematological and biochemical blood investigations, and relevant imaging.…”
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