Abstract
Background: Indications for laparoscopic liver resection (LLR) of posterosuperior segments (RSS) for colorectal liver metastases (CRLM) are commonly restricted to small, superficial lesions not adjacent to large vessels. There is no long-term survival comparative estimation after LRR and open liver resection (OLR). We aimed to compare outcomes after parenchyma-sparing LLR with extended indication and open liver resection (OLR) for CRLM located in PSS. Methods: Two Russian centers took part in the study. Patients with hemihepatectomy, extrahepatic tumors were excluded. Logistic regression was used for 1:1 propensity score matching (PSM). Results: PSS were resected in 77 patients. LLR were performed in 51 (66%) patients. Twenty pairs of patients were matched. Demographic and preoperative data are presented in the table. After matching, no differences were found in terms of blood loss, ICU and hospital stay, which were better for LLR group before PSM. No 90-day mortality was observed within both groups. After PSM, no difference was found in 5-year overall survival after LLR and OLR (78% and 63%, respectively) and 4-year disease-free survival (27% in both groups). Conclusions: Expanding indication for laparoscopic parenchyma-sparing resection of PSS for CRLM are justified in majority of patients if performed in high volume specialized centers expertized in laparoscopic liver surgery.OL01-03Demographic dataFactorsBefore matchingAfter matchingLLR (n=51)OLR (n=26)PLLR (n=20)OLR (n=20)PMedian size of largest metastatic tumor, mm40 (10-98)46 (15-100)0,38450 (15-98)44 (15-100)0,309Rate of metastases >50 mm, n (%)17 (33%)10 (39%)0,6569 (45%)7 (35%)0,519Proximity to the large hepatic vessels, n (%)12 (24%)8 (31%)0,4935 (25%)6 (30%)0,655Anatomical resection, n (%)22 (43%)9 (35%)0,4717 (35%)8 (40%)0,744Difficulty index, point7,0 (4,8-11,1)6,1 (2,9-10,7)0,0917,2 (4,8-11,8)6,4 (2,9-10,7)0,189Positive response to neoadjuvant chemo (RECIST), n (%)27 (53%)16 (62%)0,47313 (65%)12 (60%)0,744Positive response to adjuvant chemo (RECIST), n (%)36 (71%)18 (69%)0,90215 (75%)14 (70%)0,723 Open table in a new tab
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