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Open versus laparoscopic liver resection of colorectal metastases: a meta-analysis of matched patient populations

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A Correction to this article was published on 05 August 2022

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Abstract

In recent years, the management of colorectal liver metastases (CRLM) has evolved significantly. Laparoscopic liver resection is increasingly being performed, despite a lack of major randomized controlled trial evidence or widespread international consensus. The objective of this review was to compare the short- and long-term outcomes following open and laparoscopic CRLM resection. A systematic review of comparative matched population studies was performed. Evaluated endpoints included surgical outcomes and survival outcomes. Twelve studies were included in this review, reporting on 3095 patients. R0 (negative margins) rates were higher in the laparoscopic CRLM group (89.3% versus 86.9%). In addition, laparoscopic resection was associated with less blood loss (486 mls versus 648 mls, p ≤ 0.0001*) and reduced blood transfusion rates (6.7% vs. 12.2%, OR 2.13, 95% CI 1.08–4.19, p = 0.03*). Major complication rates were higher in the open CRLM group (12.5% vs. 8.1%, OR 1.74, 95% CI 1.30–2.33, p = 0.03*), as was overall hospital length of stay (median 7 versus 5.5 days, p = 0.001*). Perioperative mortality was similar between both groups, and there was no significance in 5-year overall survival for open or laparoscopic CRLM resection groups (58% and 61% respectively). Laparoscopic CRLM resection is associated with less blood loss, lower transfusion rates, major complications, and overall hospital length of stay with comparable oncological outcome.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland

    Michael E. Kelly, Matthew Fahy, Jarlath C. Bolger, Patrick A. Boland, Colm Neary, Gerry P. McEntee & John B. Conneely

  2. Dept. of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland

    Michael E. Kelly

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The original online version of this article was revised: Originally, the last author middle initial was published with error. John C. Conneely should be cited as John B. Conneely.

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Kelly, M.E., Fahy, M., Bolger, J.C. et al. Open versus laparoscopic liver resection of colorectal metastases: a meta-analysis of matched patient populations. Ir J Med Sci 191, 1531–1538 (2022). https://doi.org/10.1007/s11845-021-02780-3

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