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World Journal of Surgery

, Volume 40, Issue 7, pp 1702–1708 | Cite as

Outcomes of Laparoscopic Liver Resection for Patients with Large Colorectal Liver Metastases: A Case-Matched Analysis

  • Takeo Nomi
  • David Fuks
  • Christophe Louvet
  • Yoshiyuki Nakajima
  • Brice GayetEmail author
Original Scientific Report

Abstract

Background

Despite the expansion of laparoscopic approach in the treatment of liver tumors, limited data have been reported regarding large colorectal liver metastases (CRLMs). This study aimed at assessing the short- and long-term outcomes after laparoscopic liver resection (LLR) for large (≥5 cm) CRLMs.

Methods

This was a case-matched study (1:2) comparing patients with large (group L; ≥5 cm) and small (group S; <5 cm) CRLMs using demographic, tumor, and surgical characteristics as matching variables. Postoperative outcomes and survival data were compared in the 2 groups.

Results

Forty patients who underwent LLR for large CRLMs were matched with 80 patients with tumors <5 cm. Major hepatectomy was performed with 75.0 % of patients in Group L and 66.3 % in group S (p = 0.403). Operative time was 300 min in group L and 240 min in group S (p = 0.059). The postoperative mortality and overall morbidity rates were comparable in the 2 groups (p = 1.000 and 0.170, respectively). Postoperative major complication (Dindo–Clavien ≥3) was similar between the two groups (p = 0.072). R0 resection was achieved in 92.5 % in the group L and in 95.0 % in the group S (p = 1.000). The 5-year overall survival and recurrence-free survival were better for group S than for group L (47.3 vs. 35.4 %, p = 0.044 and 27.3 vs. 14.9 %, p = 0.042, respectively). Multivariate analysis identified positive surgical margins and synchronous presentation as prognostic factors.

Conclusion

Since LLR was performed safely with favorable oncological adequacy in selected patients with large CRLMs, tumor size should not modify the surgical approach.

Keywords

Overall Survival Liver Resection Portal Vein Embolization Laparoscopic Liver Resection Open Liver Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors thank Mahendran Govindasamy and Yoshikuni Kawaguchi for coordinating the patients’ follow-up and maintaining the prospective database that formed the basis of this study.

Compliance with ethical standards

Conflicts of interest

TN, DF, DH, CL, and YN have no conflicts of interest. BG received royalties for “Gayet bipolar forceps” (MicroFrance BG-CEV134, Integra, Plainsboro, NJ).

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Takeo Nomi
    • 1
    • 2
  • David Fuks
    • 1
  • Christophe Louvet
    • 3
  • Yoshiyuki Nakajima
    • 2
  • Brice Gayet
    • 1
    Email author
  1. 1.Department of Digestive Disease, Institut Mutualiste MontsourisUniversité Paris-DescartesParisFrance
  2. 2.Department of SurgeryNara Medical UniversityNaraJapan
  3. 3.Department of OncologyInstitut Mutualiste MontsourisParisFrance

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