Perioperative and oncologic outcomes of minimally invasive liver resection for colorectal metastases: A case–control study of 130 patients

Abstract

Our aim was to compare the perioperative and oncologic outcomes of open liver resection and minimally invasive liver resection in the management of colorectal liver metastases. Patients who underwent minimally invasive liver resection for colorectal liver metastases between January 2006 and June 2015 at a single center were identified and matched by extent of resection to consecutive open liver resection patients from the same period. Clinicopathologic characteristics, perioperative data, recurrence, and survival outcomes were collected and analyzed based on intention-to-treat. Sixty-five patients underwent minimally invasive liver resection during this period and were matched to 65 consecutive open liver resection patients, with similar baseline demographic, tumor, and chemotherapy parameters. Conversion to open occurred in 5 (7.7%) minimally invasive liver resection patients. R0 resection rates and operative times were comparable, but the estimated blood loss was less in the minimally invasive liver resection group (median 200mL vs 400mL, P<.001), as were perioperative transfusion rates (4.6% vs 15.4%, P=.04). The duration of stay was shorter after minimally invasive liver resection (median 4days vs 6days, P<.001), while major and minor complication rates were similar and no perioperative mortality was recorded. At a median follow-up of 28months, there was no difference regarding disease-free (P=.90) or overall survival (P=.37). In selected patients with colorectal liver metastases, minimally invasive liver resection resulted in similar oncologic outcomes, with decreased blood loss and shorter duration of stay compared to patients who underwent open liver resection.