Open versus laparoscopic liver resection for colorectal liver metastases located in the postero-superior segments: a sub-group analysis from the Oslo-CoMet trial

Abstract

Background: Laparoscopic liver resection of tumors located in the postero-superior segments is considered to be technically challenging. This study aimed to compare the perioperative outcomes for laparoscopic versus open resection of colorectal liver metastases located in the PS segments. Methods: This is a sub-study of the Oslo-CoMet trial. In this trial, 280 patients were randomly assigned to open or laparoscopic parenchyma-sparing liver resections of colorectal metastases. Inclusion was from February 2012 to February 2016. For the current study, patients with metastases in postero-superior segments were identified, and perioperative and short-term oncological outcomes were collected from the prospective trial database. The Accordion system and the Comprehensive Complication Index were used for grading of postoperative complications. Results: 62 patients underwent laparoscopic and 74 patients underwent open liver resections. A total of 257 lesions were removed. A total of 23 patients(31%) in open group and 16 patients(26%) in the laparoscopic group developed postoperative complications (P = 0.49).The mean comprehensive complication index was 32 in the open group and 26 in the laparoscopic group (P = 0.19) Median postoperative hospital stay was 2 days in the laparoscopic and 4 days in the open group (P < 0.001). Blood loss was slightly higher in patients assigned to laparoscopic surgery (500 vs. 250 ml, P = 0.001), whereas the operative time (median, 145 vs. 143 min) was similar between the two groups. Conclusion: In this subgroup-analysis of patients in the Oslo-Comet trial, we found similar postoperative complications rate and shorter hospital stay following laparoscopic resection of posterior-superior segments.