Laparoscopic liver resection for metastasic colorectal liver metastases. Experience in one center in Argentina

Abstract

Background: Laparoscopic liver resection (LLR) for colorectal rectal liver metastases (CRLM) is still a controversial indication. The aim of this study is to present a consecutive LLR for CRLM and to evaluate safety, feasibility, and oncologic integrity. Methods: It is a retrospective study of a consecutive LLR done in one center between Aug-2008 and Sept-2015. Patient demographics, preoperative, operative, and postoperative characteristics were analyzed. Actuarial overall survival was calculated. Results: A total of 26 LLR for CRLM. The median age was 64 years with 42% females. Synchronous liver lesions were present in 61% of patients. Preoperative chemotherapy was administered in 7 patients prior to liver resection. In 12 patients the LLR was done in simultaneous with the colon resection. 22 pure LLR (84%) and 4 hand-assisted laparoscopic (16%). There were 7 conversions to a hand-assisted laparoscopic and 5 to open surgery (19%). Extents of resection include 9 anatomic and 17 non-anatomic resections. Two first stage of two stage hepatectomy were done. Median OR time was 237 minutes (75–510), and 6 patients receive a blood transfusion. There were no perioperative deaths and 1 grade 4 and 3 grade 3A of Dindo-Clavien classification. Median length of hospital stay was 9.4 days (4–49). There was 1 R1 resection. Actuarial overall survivals at 1-, 3-, and 5-year were 90%, 55%, and 40%, respectively. Disease-free survivals at 1-, 3-, and 5-year were 82%, 49%, and 39%, respectively. Conclusions: LLR is safe, feasible, and oncologically comparable to open liver resection in selected patients.