Minimal-Invasive Versus Open Hepatectomy for Colorectal Liver Metastases: Bicentric Analysis of Postoperative Outcomes and Long-Term Survival Using Propensity Score Matching Analysis.

Knitter, Sebastian; Andreou, Andreas; Kradolfer, Daniel; Beierle, Anika Sophie; Pesthy, Sina; Eichelberg, Anne-Christine; Kästner, Anika; Feldbrügge, Linda; Krenzien, Felix; Schulz, Mareike; Banz, Vanessa; Lachenmayer, Anja; Biebl, Matthias; Schöning, Wenzel; Candinas, Daniel; Pratschke, Johann; Beldi, Guido; Schmelzle, Moritz (2020). Minimal-Invasive Versus Open Hepatectomy for Colorectal Liver Metastases: Bicentric Analysis of Postoperative Outcomes and Long-Term Survival Using Propensity Score Matching Analysis. Journal of clinical medicine, 9(12) MDPI 10.3390/jcm9124027

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Minimal-invasive hepatectomy (MIH) has been increasingly performed for benign and malignant liver lesions with most promising short-term results. However, the oncological role of MIH in the treatment of patients with colorectal liver metastases (CRLM) needs further investigation. Clinicopathological data of patients who underwent liver resection for CRLM between 2012 and 2017 at the Department of Surgery, Charité-Universitätsmedizin Berlin, and the Inselspital Bern were assessed. Postoperative outcomes und long-term survivals of patients following MIH were compared with those after conventional open hepatectomy (OH) after 1:1 propensity score matching. During the study period, 229 and 91 patients underwent liver resection for CRLM at the Charité Berlin and the Inselspital Bern, respectively. Patients who underwent MIH in one of the two centers (n = 69) were compared with a matched cohort of patients who underwent OH. MIH was associated with lower complication rates (23% vs. 44%, p = 0.011), shorter length of intensive care unit stay (ICU, 1 vs. 2 days, p = 0.043), shorter length of hospital stay (7 vs. 11 days, p < 0.0001), and a reduced need for intraoperative transfusions (12% vs. 25%, p = 0.047) compared to OH. R0 status was achieved in 93% and 75% of patients after MIH and OH, respectively (p = 0.005). After a median follow-up of 31 months, MIH resulted in similar five-year overall survival (OS) rate (56% vs. 48%, p = 0.116) in comparison to OH. MIH for CRLM is associated with lower postoperative morbidity, shorter length of ICU and hospital stay, reduced need for transfusions, and comparable oncologic outcomes compared to the established OH. Our findings suggest that MIH should be considered as the preferred method for the treatment of curatively resectable CRLM.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine > Visceral Surgery
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Visceral Surgery and Medicine

UniBE Contributor:

Andreou, Andreas; Kradolfer, Daniel; Banz Wüthrich, Vanessa; Lachenmayer, Anja; Candinas, Daniel and Beldi, Guido

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-0383

Publisher:

MDPI

Language:

English

Submitter:

Rahel Fuhrer

Date Deposited:

22 Dec 2020 17:24

Last Modified:

22 Dec 2020 17:24

Publisher DOI:

10.3390/jcm9124027

PubMed ID:

33322087

Uncontrolled Keywords:

colorectal liver metastases laparoscopic liver surgery minimal invasive surgery

BORIS DOI:

10.7892/boris.150021

URI:

https://boris.unibe.ch/id/eprint/150021

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