Laparoscopic <i>versus</i> open right hepatectomy for colorectal liver metastases after portal vein embolization: international multicentre study-Reference-Cited by-同舟云学术

Laparoscopic versus open right hepatectomy for colorectal liver metastases after portal vein embolization: international multicentre study

Published:2024-08 Issue:8 Volume:111 Page:
ISSN:0007-1323
Container-title:British Journal of Surgery
language:en
Short-container-title:

Author:

Bozkurt Emre¹²^ORCID,Sijberden Jasper P¹³⁴^ORCID,Langella Serena⁵,Cipriani Federica⁶^ORCID,Collado-Roura Francesc⁷,Morrison-Jones Victoria⁸,Görgec Burak³⁴^ORCID,Zozaya Gabriel⁹,Lanari Jacopo¹⁰,Aghayan Davit¹¹^ORCID,De Meyere Celine¹²,Fuks David¹³,Zimmiti Giuseppe¹,Ielpo Benedetto¹⁴^ORCID,Efanov Mikhail¹⁵^ORCID,Sutcliffe Robert P¹⁶,Russolillo Nadia⁵^ORCID,Gomez-Artacho Miquel⁷,Ratti Francesca⁶^ORCID,D’Hondt Mathieu¹²,Edwin Bjørn¹¹,Cillo Umberto¹⁰,Rotellar Fernando⁹,Besselink Marc G³⁴^ORCID,Primrose John N⁸,Lopez-Ben Santi⁷,Aldrighetti Luca A⁶^ORCID,Ferrero Alessandro⁵,Abu Hilal Mohammad¹⁸

Affiliation:

1. Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero , Brescia , Italy

2. Department of Surgery, Koç University School of Medicine , Istanbul , Turkey

3. Department of Surgery, Amsterdam UMC, location University of Amsterdam , Amsterdam , The Netherlands

4. Cancer Center Amsterdam , Amsterdam , The Netherlands

5. Department of General and Oncological Surgery, Umberto I Mauriziano Hospital , Turin , Italy

6. Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital , Milan , Italy

7. Servei de Cirurgia General i Digestiva, Hospital Universitari Doctor Josep Trueta de Girona , Girona , Spain

8. Department of Surgery, University Hospital Southampton NHS Foundation Trust , Southampton , UK

9. Department of Surgery, HPB and Liver Transplantation Unit, University Clinic, Universidad de Navarra, Institute of Health Research of Navarra (IdisNA) , Pamplona , Spain

10. Department of Surgical, Oncological and Gastroenterological Sciences, General Surgery 2, Hepato-pancreato-biliary Surgery and Liver Transplantation, Padua University Hospital , Padua , Italy

11. The Intervention Centre and Department of HPB Surgery, Oslo University Hospital and Institute of Medicine, University of Oslo , Oslo , Norway

12. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital , Kortrijk , Belgium

13. Department of Digestive, Oncologic and Metabolic Surgery, Institut Mutualiste Montsouris, Université Paris Descartes , Paris , France

14. Hepatobiliary and Pancreatic Surgery Unit, Hospital del Mar, Hospital del Mar Medical Research Institute (IMIM), Universitat Pompeu Fabra , Barcelona , Spain

15. Department of Hepato-Pancreato-Biliary Surgery, Moscow Clinical Research Centre , Moscow , Russia

16. Liver Unit, Queen Elizabeth Hospital , Birmingham , UK

Abstract

Abstract Background Laparoscopic liver surgery is increasingly used for more challenging procedures. The aim of this study was to assess the feasibility and oncological safety of laparoscopic right hepatectomy for colorectal liver metastases after portal vein embolization. Methods This was an international retrospective multicentre study of patients with colorectal liver metastases who underwent open or laparoscopic right and extended right hepatectomy after portal vein embolization between 2004 and 2020. The perioperative and oncological outcomes for patients who underwent laparoscopic and open approaches were compared using propensity score matching. Results Of 338 patients, 84 patients underwent a laparoscopic procedure and 254 patients underwent an open procedure. Patients in the laparoscopic group less often underwent extended right hepatectomy (18% versus 34.6% (P = 0.004)), procedures in the setting of a two-stage hepatectomy (42% versus 65% (P < 0.001)), and major concurrent procedures (4% versus 16.1% (P = 0.003)). After propensity score matching, 78 patients remained in each group. The laparoscopic approach was associated with longer operating and Pringle times (330 versus 258.5 min (P < 0.001) and 65 versus 30 min (P = 0.001) respectively) and a shorter length of stay (7 versus 8 days (P = 0.011)). The R0 resection rate was not different (71% for the laparoscopic approach versus 60% for the open approach (P = 0.230)). The median disease-free survival was 12 (95% c.i. 10 to 20) months for the laparoscopic approach versus 20 (95% c.i. 13 to 31) months for the open approach (P = 0.145). The median overall survival was 28 (95% c.i. 22 to 48) months for the laparoscopic approach versus 42 (95% c.i. 35 to 52) months for the open approach (P = 0.614). Conclusion The advantages of a laparoscopic over an open approach for (extended) right hepatectomy for colorectal liver metastases after portal vein embolization are limited.

Publisher

Oxford University Press (OUP)

Link

https://academic.oup.com/bjs/article-pdf/111/8/znae181/58904618/znae181.pdf