Abstract
Background. Over the last decades, liver resection has become a frequently performed procedure in western countries because of its acceptance as the most effective treatment for patients with selected cases of metastatic tumours. The purpose of this study was to evaluate the results after hepatic resections performed electively in our centre since 1979 and compare the results to those of larger high-volume centres. Methods. Medical records of all patients who underwent liver resection from January 1979 to December 2011 were reviewed. Disease-free survival and overall survival were determined by Kaplan-Meier analysis. Risk factors for complications were tested with the log-rank test and the Cox proportional hazard model. Complications were classified according to the modified Clavien classification system. Results. 290 elective liver resections were performed between January 1979 and December 2011. There were 171 males (59.0%) and 119 females (41.0%). Median age was 63 years, range 1–87. Overall survival ranged from 0 to 383 months, with a median of 31 months. Five-year survival rate for patients who underwent liver resection for colorectal metastases was 35.8% (34/95). Discussion. Hepatic resections are safely performed at a low-volume centre, with regard to perioperative- and in-house mortality and 5-year survival rates.
Highlights
Modern liver surgery has developed steadily over the last 30 years
ISRN Surgery particular, we have investigated the results of liver surgery for C/R metastases
A spreadsheet was created for registration of: age, gender, indication for liver resection, type of resection, previous hepatic resections, combined surgery, segments resected, duration of surgery, use of epidural anaesthesia, volume of blood loss, amount and types of fluids received intraoperatively, amount and types of blood product received, use of drains, types of complications, length-of-stay (LOS) until discharge or transferral to primary centre
Summary
Modern liver surgery has developed steadily over the last 30 years. The demonstration of long-term cure after resection of liver metastases from colorectal (C/R) cancer in the 1970’s [1] and modern immunological therapies making liver transplantations common procedures [2] constituted the most important driving forces. From a time when liver resections were dramatic and rare procedures, it has become both commonly performed and safe surgery [3,4,5,6]. Liver resection has become a frequently performed procedure in western countries because of its acceptance as the most effective treatment for patients with selected cases of metastatic tumours. Medical records of all patients who underwent liver resection from January 1979 to December 2011 were reviewed. 290 elective liver resections were performed between January 1979 and December 2011. Five-year survival rate for patients who underwent liver resection for colorectal metastases was 35.8% (34/95). Hepatic resections are safely performed at a low-volume centre, with regard to perioperative- and in-house mortality and 5-year survival rates
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