Does Pringle Maneuver Affect Survival in Patients with Colorectal Liver Metastases?

Abstract

The purpose of this original article was to evaluate the impact of the Pringle maneuver on the survival of patients with colorectal liver metastases. Eighty patients with colorectal liver metastases were randomized to undergo hepatectomy with (39 patients, HPC group) or without (41 patients, NHPC group) pedicle clamping. The two groups were homogeneous. Mortality and morbidity rates were similar. Blood transfusions rates were higher in HPC group (p = 0.010). Median follow-up was 67.1 +/- 20 months in the HPC group and 77.5 +/- 16.6 months in the other group (p = 0.07). Overall survival at 1, 3, and 5 years was 100%, 86.1%, and 49.4% in HPC group vs. 92.6%, 65.8%, and 48.2% in NHPC group (p = 0.704). Disease-free survival was similar between the two groups: 1-, 3- and 5-year survival rates were 85.7%, 51.4%, and 34.3% in the HPC group vs. 84%, 51.5%, and 37.9% in NHPC group (p = 0.943). The incidence of hepatic recurrence was similar in the two groups (p = 0.506). Median time to hepatic recurrence was similar in the two groups (p = 0.482). Overall and disease-free survival rates were similar even when the Pringle maneuver was longer than 45 min (p = 0.571 and 0.948) and in patients with liver steatosis (p = 0.779 and 0.412). The Pringle maneuver does not seem to affect the survival of patients with liver metastases.