INTRODUCTION: The liver is the most common site of colorectal metastases (colorectal liver metastases - CLM). Surgical treatment in combination with oncological therapy is the only potentially curative method. Unfortunately, only 10-25% of patients are suitable for surgery. Traditionally, open liver resection (OLR) is usually performed. However, laparoscopic liver resection (LLR) has become popular worldwide in the last two decades. AIM: To evaluate the effectiveness and benefits of radiofrequency minor LLR of CLM in comparison with OLR. MATERIAL AND METHODS: The indication for surgery was CLM and the possibility to perform minor laparoscopic or OLR not exceeding two hepatic segments according to Couinaud's classification. RESULTS: Sixty-six minor liver resections for CLM were performed. Twenty-five (37.9%) patients underwent a laparoscopic approach and 41 (62.1%) patients underwent OLR. The mean operative time was 166.4 min for LLR and 166.8 min for OLR. Average blood loss was 132.3 ±218.0 ml during LLR and 149.5 ±277.5 ml during OLR. Length of hospital stay was 8.4 ±2.0 days for LLR and 10.5 ±5.8 days for OLR. All resections were R0. There was no case of mortality. Postoperative complications were recognized in 9 (13.6%) patients: 8 in the group of OLR patients and 1 in the LLR group. The median survival time for LLR was 70.5 months and for OLR 61.9 months. The 5-year overall survival rate was higher for LLR vs. OLR - 82.1% vs. 69.8%. The average length of disease-free interval after LLR was greater (52.2 months) in comparison with OLR (49.4%). The 5-year disease-free interval was 63.2% for LLR and 58% for OLR. CONCLUSIONS: Outcomes and oncological radicality of minor laparoscopic liver resections of CLM are comparable to outcomes of OLR.

Imperial College London London United Kingdom

University Hospital Ostrava Ostrava Czech Republic

University Hospital Ostrava Ostrava Czech Republic ; University of Ostrava Ostrava Czech Republic

University Hospital Ostrava Ostrava Czech Republic ; VŠB Techcnical University of Ostrava Ostrava Czech Republic ; Imperial College London London United Kingdom ; University of Ostrava Ostrava Czech Republic

VŠB Techcnical University of Ostrava Ostrava Czech Republic

See more in PubMed

Blumgart LH. Surgery of the liver, biliary tract, and pancreas. Philadelphia, US: Saunders, Elsevier; 2007.

Hurwitz H, Fehrenbacher L, Novotny W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004;350:2335–42. PubMed

El-Gendi AM, Vavra P, Elkayal E, et al. Radiofrequency assisted hepatic resection: a new technique using a bipolar device. J Hepatol. 2010;52:S189.

Adam R, Pascal G, Azoulay D, et al. Liver resection for colorectal metastases: the third hepatectomy. Ann Surg. 2003;238:871–83. PubMed PMC

El-Gendi AM, Khorsandi SE, Pai M, et al. Repeat hepatic resection using a radiofrequency-assisted technique. Dig Surg. 2008;25:293–9. PubMed

Cunningham D, Humblet Y, Siena S, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med. 2004;351:337–45. PubMed

Hosmer DW, Lemeshow S, May S. Applied survival analysis: regression modeling of time to event data. Hoboken, US: Wiley; 2008.

Gagner M, Rheault M, Dubuc J. Laparoscopic partial hepatectomy for liver tumor. Surg Endosc. 1993;6:99.

Frączek M, Sobocki J, Pędziwiatr K, et al. Robotic stereotactic body radiation therapy for liver-limited malignant tumors. Videosurgery Miniinv. 2014;9:511–6. PubMed PMC

Dagher I, Proske JM, Carloni A, et al. Laparoscopic liver resection: results for 70 patients. Surg Endosc. 2007;21:619–24. PubMed

Topal B, Fieuws S, Aerts R, et al. Laparoscopic versus open liver resection of hepatic neoplasms: comparative analysis of short-term results. Surg Endosc. 2008;22:2208–13. PubMed

Mala T, Edwin B, Rosseland AR, et al. Laparoscopic liver resection: experience of 53 procedures at a single center. J Hepatobiliary Pancreat Surg. 2005;12:298–303. PubMed

Bryant R, Laurent A, Tayar C, et al. Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience. Ann Surg. 2009;250:103–11. PubMed

Buell JF, Thomas MT, Doty TC, et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery. 2004;136:804–11. PubMed

Buell JF, Thomas MT, Rudich S, et al. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg. 2008;248:475–86. PubMed

Koffron AJ, Auffenberg G, Kung R, Abecassis M. Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg. 2007;246:385–92. PubMed PMC

Cho JY, Han HS, Yoon YS, Shin SH. Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver. Surg Endosc. 2008;22:2344–9. PubMed

Nguyen KT, Marsh JW, Tsung A, et al. Comparative benefits of laparoscopic vs. open hepatic resection: a critical appraisal. Arch Surg. 2011;146:348–56. PubMed

Han HS, Cho JY, Yoon YS. Techniques for performing laparoscopic liver resection in various hepatic locations. J Hepatobiliary Pancreat Surg. 2009;16:427–32. PubMed

Vavra P, Ihnat P, Vavrova M, et al. Hand-assisted laparoscopic liver resection using Habib′s technique: early experience. Videosurgery Miniinv. 2012;7:8–12. PubMed PMC

Zacharoulis D, Khorsandi SE, Vavra P, et al. Pilot study for a new bipolar radiofrequency ablation/aspirator device in the management of primary and secondary liver cancers. Liver Int. 2009;29:824–30. PubMed

Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg. 2009;250:825–30. PubMed

Koffron A, Geller D, Gamblin TC, Abecassis M. Laparoscopic liver surgery: shifting the management of liver tumors. Hepatology. 2006;44:1694–700. PubMed

Cho JY, Han HS, Yoon YS, Shin SH. Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location. Surgery. 2008;144:32–8. PubMed

Cho A, Yamamoto H, Kainuma O, et al. Safe and feasible extrahepatic Glissonean access in laparoscopic anatomical liver resection. Surg Endosc. 2011;25:1333–6. PubMed

Abu Hilal M, Di Fabio F, Teng MJ, et al. Single-centre comparative study of laparoscopic versus open right hepatectomy. J Gastrointest Surg. 2011;15:818–23. PubMed

Polignano FM, Quyn AJ, De Figueiredo RS, et al. Laparoscopic versus open liver segmentectomy: prospective, case-matched, intention-to-treat analysis of clinical outcomes and cost effectiveness. Surg Endosc. 2008;22:2564–70. PubMed

Kaneko H, Takagi S, Otsuka Y, et al. Laparoscopic liver resection of hepatocellular carcinoma. Am J Surg. 2005;189:190–4. PubMed

Simillis C, Constantinides VA, Tekkis PP, et al. Laparoscopic versus open hepatic resections for benign and malignant neoplasms: a meta-analysis. Surgery. 2007;141:203–11. PubMed

Tranchart H, Di Giuro G, Lainas P, et al. Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg Endosc. 2010;24:1170–6. PubMed

Castaing D, Vibert E, Ricca L, et al. Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg. 2009;250:849–55. PubMed

Belli G, Limongelli P, Fantini C, et al. Laparoscopic and open treatment of hepatocellular carcinoma in patients with cirrhosis. Br J Surg. 2009;96:1041–8. PubMed

Morino M, Morra I, Rosso E, et al. Laparoscopic vs open hepatic resection: a comparative study. Surg Endosc. 2003;17:1914–8. PubMed

Belli G, Fantini C, D'Agostino A, et al. Laparoscopic versus open liver resection for hepatocellular carcinoma in patients with histologically proven cirrhosis: short- and middle-term results. Surg Endosc. 2007;21:2004–11. PubMed

Dagher I, Di Giuro G, Dubrez J, et al. Laparoscopic versus open right hepatectomy: a comparative study. Am J Surg. 2009;198:173–7. PubMed

Farges O, Jagot P, Kirstetter P, et al. Prospective assessment of the safety and benefit of laparoscopic liver resections. J Hepatobiliary Pancreat Surg. 2002;9:242–8. PubMed

Aldrighetti L, Pulitano C, Catena M, et al. A prospective evaluation of laparoscopic versus open left lateral hepatic sectionectomy. J Gastrointest Surg. 2008;12:457–62. PubMed

Troisi R, Montalti R, Smeets P, et al. The value of laparoscopic liver surgery for solid benign hepatic tumors. Surg Endosc. 2008;22:38–44. PubMed

Lesurtel M, Cherqui D, Laurent A, et al. Laparoscopic versus open left lateral hepatic lobectomy: a case-control study. J Am Coll Surg. 2003;196:236–42. PubMed

Rau HG, Buttler E, Meyer G, et al. Laparoscopic liver resection compared with conventional partial hepatectomy: a prospective analysis. Hepatogastroenterology. 1998;45:2333–8. PubMed

Mala T, Edwin B, Gladhaug I, et al. A comparative study of the short-term outcome following open and laparoscopic liver resection of colorectal metastases. Surg Endosc. 2002;16:1059–63. PubMed

Laurent A, Cherqui D, Lesurtel M, et al. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg. 2003;138:763–9. PubMed

Ito K, Ito H, Are C, et al. Laparoscopic versus open liver resection: a matched-pair case control study. J Gastrointest Surg. 2009;13:2276–83. PubMed

Tsinberg M, Teliioglu G, Simpfendorfer CH, et al. Comparison of laparoscopic versus open liver tumor resection: a case-controlled study. Surg Endosc. 2009;23:847–53. PubMed

Cai XJ, Yang J, Yu H, et al. Clinical study of laparoscopic versus open hepatectomy for malignant liver tumors. Surg Endosc. 2008;22:2350–6. PubMed

Cai XJ, Wang Y, Yu H, et al. Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Surg Endosc. 2007;21:1074–8. PubMed

Lai EC, Tang CM, Ha JP, Li MK. Laparoscopic liver resection for hepatocellular carcinoma: ten-year experience in a single center. Arch Surg. 2009;144:143–7. PubMed

Lee KF, Cheung YS, Chong CN, et al. Laparoscopic versus open hepatectomy for liver tumours: a case control study. Hong Kong Med J. 2007;13:442–8. PubMed

Shimada M, Hashizume M, Maehara S, et al. Laparoscopic hepatectomy for hepatocellular carcinoma. Surg Endosc. 2001;15:541–4. PubMed

Endo Y, Ohta M, Sasaki A, et al. A comparative study of the long-term outcomes after laparoscopy-assisted and open left lateral hepatectomy for hepatocellular carcinoma. Surg Laparosc Endosc Percutan Tech. 2009;19:e171–4. PubMed

Tang CN, Li MK. Hand-assisted laparoscopic segmentectomy in recurrent pyogenic cholangitis. Surg Endosc. 2003;17:324–7. PubMed

Mamada Y, Yoshida H, Taniai N, et al. Usefulness of laparoscopic hepatectomy. J Nippon Med Sch. 2007;4:158–62. PubMed

Abu Hilal M, Underwood T, Zuccaro M, et al. Short- and medium-term results of totally laparoscopic resection for colorectal liver metastases. Br J Surg. 2010;97:927–33. PubMed

Rowe AJ, Meneghetti AT, Schumacher PA, et al. Perioperative analysis of laparoscopic versus open liver resection. Surg Endosc. 2009;23:1198–203. PubMed

O'Rourke N, Shaw I, Nathanson L, et al. Laparoscopic resection of hepatic colorectal metastases. HPB (Oxford) 2004;6:230–5. PubMed PMC

Vigano L, Tayar C, Laurent A, Cherqui D. Laparoscopic liver resection: a systematic review. J Hepatobiliary Pancreat Surg. 2009;16:410–21. PubMed

Mizuguchi T, Kawamoto M, Meguro M, et al. Laparoscopic hepatectomy: a systematic review, meta-analysis, and power analysis. Surg Today. 2011;41:39–47. PubMed

Sarpel U, Hefti MM, Wisnievsky JP, et al. Outcome for patients treated with laparoscopic versus open resection of hepatocellular carcinoma: case-matched analysis. Ann Surg Oncol. 2009;16:1572–7. PubMed

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