• Toru Beppu, Go Wakabayashi, Kiyoshi Hasegawa, Naoto Gotohda, Toru Mizuguchi, Yutaka Takahashi, Fumitoshi Hirokawa, Nobuhiko Taniai, Manabu Watanabe, Masato Katou, Hiroaki Nagano, Goro Honda, Hideo Baba, Norihiro Kokudo, Masaru Konishi, Koichi Hirata, Masakazu Yamamoto, Kazuhisa Uchiyama, Eiji Uchida, Shinya Kusachi, Keiichi Kubota, Masaki Mori, Keiichi Takahashi, Ken Kikuchi, Hiroaki Miyata, Takeshi Takahara, Masafumi Nakamura, Hironori Kaneko, Hiroki Yamaue, Masaru Miyazaki, and Tadahiro Takada.
• Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
• J Hepatobiliary Pancreat Sci. 2015 Oct 1; 22 (10): 711-20.

BackgroundThe aim of the present study was to clarify the surgical outcome and long-term prognosis of laparoscopic liver resection (LLR) compared with conventional open liver resection (OLR) in patients with colorectal liver metastases (CRLM).MethodsA one-to-two propensity score matching (PSM) analysis was applied. Covariates (P < 0.2) used for PSM estimation included preoperative levels of CEA and CA19-9; primary tumor differentiation; primary pathological lymph node metastasis; number, size, location, and distribution of CRLM; existence of extrahepatic metastasis; extent of hepatic resection; total bilirubin and prothrombin activity levels; and preoperative chemotherapy. Perioperative data and long-term survival were compared.ResultsFrom 2005 to 2010, 1,331 patients with hepatic resection for CRLM were enrolled. By PSM, 171 LLR and 342 OLR patients showed similar preoperative clinical characteristics. Median estimated blood loss (163 g vs 415 g, P < 0.001) and median postoperative hospital stay (12 days vs 14 days; P < 0.001) were significantly reduced in the LLR group. Morbidity and mortality were similar. Five-year rates of recurrence-free, overall, and disease-specific survival did not differ significantly. The R0 resection rate was similar.ConclusionsIn selected CRLM patients, LLR is strongly associated with lower blood loss and shorter hospital stay and has equivalent long-term survival comparable with OLR.© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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