Impact of Immune Response in Short-term and Long-term Outcomes After Minimally Invasive Surgery for Colorectal Liver Metastases

Abstract Background Minimally invasive liver surgery (MILS) in the treatment of colorectal liver metastases (CRLM) is increasing in incidence. The aim of this work was to present our experience by reporting short-term and long-term outcomes after MILS for CRLM with comparative analysis of laparoscopic (LLS) and robotic liver surgery (RLS). Methods Twenty-five patients with CRLM, who underwent MILS between May 2012 and March 2020, were selected from our retrospective registry of minimally invasive liver surgery (MD-MILS). Thirteen of these patients underwent LLS and 12 RLS. Short-term and long-term outcomes of both groups were analyzed. Results Operating time was significantly longer in the RLS vs. the LLS group (342.0 vs. 200.0 min; p = 0.004). There was no significant difference between the laparoscopic vs. the robotic group regarding length of postoperative stay (8.8 days), measured blood loss (430.4 ml), intraoperative blood transfusion, overall morbidity (20.0%), and liver surgery related morbidity (4%). The mean BMI was 27.3 (range from 19.2 to 44.8) kg/m2. The 30-day mortality was 0%. R0 resection was achieved in all patients (100.0%) in RLS vs. 10 patients (76.9%) in LLS. Major resections were carried out in 32.0% of the cases, and 84.0% of the patients showed intra-abdominal adhesions due to previous abdominal surgery. In 24.0% of cases, the tumor was bilobar, the maximum number of tumors removed was 9, and the largest tumor was 8.5 cm in diameter. The 1-, 3- and 5-year overall survival rates were 84, 56.9, and 48.7%, respectively. The 1- and 3-year overall recurrence-free survival rates were 49.6 and 36.2%, respectively, without significant differences between RLS vs. LLS. Conclusion Minimally invasive liver surgery for CRLM is safe and feasible. Minimally invasive resection of multiple lesions and large tumors is also possible. RLS may help to achieve higher rates of R0 resections. High BMI, previous abdominal surgery, and bilobar tumors are not a barrier for MILS. Laparoscopic and robotic liver resections for CRLM provide similar long-term results which are comparable to open techniques.

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Short-term and long-term outcomes of hepatectomy combined with intraoperative radiofrequency ablation for multiple colorectal liver metastases: A propensity score matching study

Annals of Oncology ◽

10.1093/annonc/mdz421.039 ◽

2019 ◽

Vol 30 ◽

pp. ix40

Author(s):

W. Huang ◽

Y. Chen ◽

W. Chang ◽

Y. Wei ◽

J. Xu

Keyword(s):

Radiofrequency Ablation ◽

Propensity Score ◽

Liver Metastases ◽

Propensity Score Matching ◽

Colorectal Liver Metastases ◽

Long Term Outcomes ◽

Short Term

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Minimally invasive compared to open re-hepatectomy for colorectal liver metastases: A multi-institutional propensity-matched analysis of short and long-term outcomes

HPB ◽

10.1016/j.hpb.2016.02.394 ◽

2016 ◽

Vol 18 ◽

pp. e166

Author(s):

J. Hallet ◽

A. Sa Cunha ◽

R. Adam ◽

B. Gayet ◽

D. Goéré ◽

...

Keyword(s):

Minimally Invasive ◽

Liver Metastases ◽

Colorectal Liver Metastases ◽

Long Term Outcomes ◽

Short And Long Term

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Comparison of long-term outcomes of minimally invasive surgery versus open radical hysterectomy for cervical cancer: A meta-analysis

Authorea ◽

10.22541/au.158465441.13069294 ◽

2020 ◽

Author(s):

Jun Liu ◽

Ting Chen ◽

Min qi Liao ◽

Da fang Cao ◽

Xiao xuan Yu ◽

...

Keyword(s):

Cervical Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Radical Hysterectomy ◽

Meta Analysis ◽

Long Term Outcomes

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The Advances of Laparoscopic Gastrectomy for Gastric Cancer

Gastroenterology Research and Practice ◽

10.1155/2017/9278469 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Yeon-Ju Huh ◽

Joo-Ho Lee

Keyword(s):

Gastric Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Laparoscopic Gastrectomy ◽

Minimal Invasive ◽

Long Term Outcomes ◽

Short And Long Term

Laparoscopic gastrectomy is evolving. With the increasing expertise and experience of oncologic surgeons in the minimally invasive surgery for gastric cancer, the indication for laparoscopic gastrectomy is expanding to advanced cases. Many studies have demonstrated the benefits of minimally invasive surgery, including reduced risk of surgery-related injury, reduced blood loss, less pain, and earlier recovery. In order to establish concrete evidence for the suitability of minimal invasive surgery for gastric cancer, many multicenter RCTs, comparing the short- and long-term outcomes of laparoscopic versus open surgery, are in progress. Advances in laparoscopic gastrectomy are moving toward increasingly minimally invasive approaches that enable the improvement of the quality of life of patients, without compromising on oncologic safety.

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Repeat hepatic resection for recurrent colorectal liver metastases: Evaluation of short-term and long-term outcomes

HPB ◽

10.1016/j.hpb.2016.01.161 ◽

2016 ◽

Vol 18 ◽

pp. e722

Author(s):

C.P. Neal ◽

G. Nana ◽

V. Cairns ◽

A.R. Dennison ◽

G. Garcea

Keyword(s):

Liver Metastases ◽

Hepatic Resection ◽

Colorectal Liver Metastases ◽

Long Term Outcomes ◽

Short Term ◽

Repeat Hepatic Resection

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Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.726217 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jie Gong ◽

Fengwei Gao ◽

Qingyun Xie ◽

Xin Zhao ◽

Zehua Lei

Keyword(s):

Colorectal Cancer ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Liver Metastases ◽

Invasive Surgery ◽

Open Surgery ◽

Colorectal Liver Metastases ◽

Disease Free Survival ◽

Simultaneous Resection ◽

Synchronous Colorectal Liver Metastases

Background: We performed a meta-analysis to evaluate the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases.Methods: A systematic literature search up to April 2021 was done and 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery. They were reporting relationships between the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to assess the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases using the dichotomous or continuous method with a random or fixed-effect model.Results: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time (MD, 35.61; 95% CI, 7.36–63.87, p = 0.01), less blood loss (MD, −151.62; 95% CI, −228.84 to −74.40, p < 0.001), less blood transfusion needs (OR, 0.61; 95% CI, 0.42–0.89, p = 0.01), shorter length of hospital stay (MD, −3.26; 95% CI, −3.67 to −2.86, p < 0.001), lower overall complications (OR, 0.59; 95% CI, 0.45–0.79, p < 0.001), higher overall survival (OR, 1.66; 95% CI, 1.21–2.29, p = 0.002), and higher disease-free survival (OR, 1.49; 95% CI, 1.13–1.97, p = 0.005) compared to open surgery.Conclusions: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases may have less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival with longer operation time compared with the open surgery. Furthers studies are required to validate these findings.

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