• Riccardo Memeo, Vito de Blasi, René Adam, Diane Goéré, Daniel Azoulay, Ahmet Ayav, Emilie Gregoire, Reza Kianmanesh, Francis Navarro, Sa CunhaAntonioADepartment of Surgery, Hôpital Paul Brousse, Villejuif, France., Patrick Pessaux, and French Colorectal Liver Metastases Working Group, Association Française de Chirurgie (AFC).
• Institut Hospitalo-Universitaire (IHU), Institute for Minimally Invasive Hybrid Image-Guided Surgery, Université de Strasbourg, Strasbourg, France; Institut de Recherche Contre les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France; General, Digestive, and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg, France.
• HPB (Oxford). 2016 Sep 1; 18 (9): 781-90.

ObjectiveThe aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM).BackgroundThe surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver. Two approaches are adaptable as follows: parenchymal-sparing hepatectomies (PSH) and extended hepatectomies (NON-PSH).MethodsA total of 3036 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched in a 1:1 propensity score analysis in order to compare PSH versus NON-PSH resections.ResultsPSH was associated with a lower number of complications (≥1) (25% vs. 34%, p = 0.04) and a lower grade of Dindo-Clavien III and IV (10 vs. 16%, p = 0.03). Liver failure was less present in PSH (2 vs. 7%, p = 0.006), with a shorter ICU stay (0 day vs. 1 day, p = 0.004). No differences were demonstrated in overall and disease-free survival.ConclusionIn conclusion, PSH resection for bilobar multiple CLMs represents a valid alternative to NON-PSH resection in selected patients with a reduced morbidity and comparable oncological results.Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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