eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2015
vol. 10
 
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abstract:
Original paper

Colorectal cancer liver metastases: laparoscopic and open radiofrequency-assisted surgery

Petr Vavra
,
Jana Nowakova
,
Petr Ostruszka
,
Martin Hasal
,
Jana Jurcikova
,
Lubomir Martinek
,
Marek Penhaker
,
Peter Ihnat
,
Nagy Habib
,
Pavel Zonca

Videosurgery Miniinv 2015; 10 (2): 205–212
DOI: https://doi.org/10.5114/wiitm.2015.52082
Online publish date: 2015/06/08
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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.
keywords:

colorectal cancer, liver metastases, laparoscopic liver resection, radiofrequency
  
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