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Long‐term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi‐institutional Japanese study
Author(s) -
Beppu Toru,
Wakabayashi Go,
Hasegawa Kiyoshi,
Gotohda Naoto,
Mizuguchi Toru,
Takahashi Yutaka,
Hirokawa Fumitoshi,
Taniai Nobuhiko,
Watanabe Manabu,
Katou Masato,
Nagano Hiroaki,
Honda Goro,
Baba Hideo,
Kokudo Norihiro,
Konishi Masaru,
Hirata Koichi,
Yamamoto Masakazu,
Uchiyama Kazuhisa,
Uchida Eiji,
Kusachi Shinya,
Kubota Keiichi,
Mori Masaki,
Takahashi Keiichi,
Kikuchi Ken,
Miyata Hiroaki,
Takahara Takeshi,
Nakamura Masafumi,
Kaneko Hironori,
Yamaue Hiroki,
Miyazaki Masaru,
Takada Tadahiro
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.261
Subject(s) - medicine , propensity score matching , perioperative , colorectal cancer , metastasis , hepatectomy , surgery , gastroenterology , resection , cancer
Background The 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). Methods A 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. Results From 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. Conclusions In selected CRLM patients, LLR is strongly associated with lower blood loss and shorter hospital stay and has equivalent long‐term survival comparable with OLR.