Open liver resection for colorectal metastases: better short- and long-term outcomes in patients potentially suitable for laparoscopic liver resection

Prior studies of laparoscopic liver resection (LLR) have evaluated long-term outcomes in terms of cancer survival, but few have evaluated nononcologic outcomes. This study analyzes long-term nondisease-specific complications associated with LLR and open liver resection (OLR). We performed a retrospective single-institution review of patients undergoing liver resection for any reason from January 2005 to December 2014. Long-term complication was defined as any complication not related to the primary disease process, and occurring more than 90 days after surgery, emphasizing incisional hernia (IH) and small bowel obstruction (SBO). A total of 208 patients were included in the OLR group and 79 patients in the LLR group. Forty-one patients (19.6%) developed IH after OLR, whereas only six patients (7.5%) developed IH after LLR ( P = 0.01). About 3.8 per cent of patients developed IH requiring surgical repair in both groups. Seven patients developed SBO (3.4%) after OLR; no patient developed SBO after LLR. Median time to development of complications was 13.8 months (range 3–54 months) after OLR compared with 8.5 months after LLR (range 6–36 months). Male gender, body mass index, prior abdominal surgery, and OLR were independent risk factors for development of long-term complications. There is a higher incidence of nondisease-specific complications after OLR than LLR.

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Short and long-term outcomes after laparoscopic or robotic liver resection in patients with HCC located in posterosuperior segments: comparision with open liver resection

HPB ◽

10.1016/j.hpb.2018.06.2901 ◽

2018 ◽

Vol 20 ◽

pp. S467

Author(s):

J.U. Chong ◽

G.H. Choi ◽

D.H. Han ◽

J.S. Choi

Keyword(s):

Liver Resection ◽

Long Term Outcomes ◽

Open Liver Resection ◽

Robotic Liver Resection ◽

Posterosuperior Segments ◽

Short And Long Term

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Systematic Review and Meta-Analysis of Liver Resection for Colorectal Metastases in Elderly Patients

Digestive Surgery ◽

10.1159/000487274 ◽

2018 ◽

Vol 36 (2) ◽

pp. 111-123 ◽

Cited By ~ 8

Author(s):

Tim van Tuil ◽

Ali A. Dhaif ◽

Wouter W. te Riele ◽

Bert van Ramshorst ◽

Hjalmar C. van Santvoort

Keyword(s):

Systematic Review ◽

Liver Resection ◽

Elderly Patients ◽

Postoperative Morbidity ◽

Meta Analysis ◽

Colorectal Metastases ◽

Cochrane Library ◽

Long Term Outcomes ◽

Short And Long Term

Background: This systematic review and meta-analysis evaluated the short- and long-term outcomes of liver resection for colorectal liver metastases (CRLM) in elderly patients. Methods: A PubMed, EMBASE, and Cochrane Library search was performed from January 1995 to April 2017, for studies comparing both short- and long-term outcomes in younger and elderly patients undergoing liver resection for CRLM. Results: Eleven studies comparing patients aged <70 years with patients aged >70 years and 4 studies comparing patients aged <75 years with patients aged >75 years were included. Postoperative morbidity was similar in patients aged >70 years (27 vs. 30%; p = 0.35) but higher in patients aged >75 years (21 vs. 32%; p = 0.001). Postoperative mortality was higher in both patients aged >70 years (2 vs. 4%; p = 0.01) and in patients aged >75 years (1 vs. 6%; p = 0.02). Mean 5-year overall survival was lower in patients aged >70 years (40 vs. 32%; p < 0.001) but equal in patients aged >75 years (42 vs. 32%; p = 0.06). Conclusion: Although postoperative morbidity and mortality were increased with higher age, liver resection for CRLM seems justified in selected elderly patients.

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