Laparoscopic liver resection as a safe and efficacious alternative to open resection for colorectal liver metastasis: a meta-analysis

BMC Surgery

Hua Li²  Bin Li¹  Lupeng Wu¹  Yaqing Xiao²  Yanming Zhou¹ 

[1] Department of Hepatobiliary & Pancreatovascular Surgery, Oncologic Center of Xiamen, First affiliated Hospital of Xiamen University, Xiamen, China;Department of Digestive Diseases, First affiliated Hospital of Xiamen University, Xiamen, China

关键词: Meta-analysis;    Colorectal liver metastasis;    Laparoscopic liver resection;   

Others  :  1123320
DOI  :  10.1186/1471-2482-13-44

 received in 2013-06-04, accepted in 2013-09-27,  发布年份 2013

【 摘 要 】

Background

The safety and efficacy of laparoscopic liver resection (LLR) for colorectal liver metastasis (CLM) remain to be established. A meta-analysis was undertaken to compare LLR and open liver resection (OLR) for CLM with respect to surgical and oncologic outcomes.

Methods

An electronic search was performed to retrieve all relevant articles published in the English language by the end of March 2013. Data were analyzed using Review Manager version 5.0.

Results

A total of 8 nonrandomized controlled studies with 695 subjects were analyzsed. Intra-operative blood loss, the proportion of patients requiring blood transfusion, morbidity and the length of hospital stay were all significantly reduced after LLR. Postoperative recurrence, 5-year overall and disease-free survivals were comparable between two groups.

Conclusions

LLR for CLM is safe and efficacious. It improves surgical outcomes and uncompromises oncologic outcomes as compared with OLR.

【 授权许可】

   
2013 Zhou et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

【 参考文献 】

• [1]Mohammad WM, Balaa FK: Surgical management of colorectal liver metastases. Clin Colon Rectal Surg 2009, 22:225-232.
• [2]Kanas GP, Taylor A, Primrose JN, et al.: Survival after liver resection in metastatic colorectal cancer: review and meta-analysis of prognostic factors. Clin Epidemiol 2012, 4:283-301.
• [3]Reich H, McGlynn F, DeCaprio J, et al.: Laparoscopic excision of benign liver lesions. Obstet Gynecol 1991, 78:956-958.
• [4]Nguyen KT, Gamblin TC, Geller DA: World review of laparoscopic liver resection-2,804 patients. Ann Surg 2009, 250:831-841.
• [5]Gigot JF, Glineur D, Santiago Azagra J, et al.: Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study. Ann Surg 2002, 236:90-97.
• [6]O’Rourke N, Shaw I, Nathanson L, et al.: Laparoscopic resection of hepatic colorectal metastases. HPB (Oxford) 2004, 6:230-235.
• [7]Vibert E, Perniceni T, Levard H, et al.: Laparoscopic liver resection. Br J Surg 2006, 93:67-72.
• [8]Tang CN, Tsui KK, Ha JP, et al.: A single-centre experience of 40 laparoscopic liver resections. Hong Kong Med J 2006, 12:419-425.
• [9]Mala T, Edwin B, Gladhaug I, et al.: A comparative study of the short-term outcome following open and laparoscopic liver resection of colorectal metastases. Surg Endosc 2002, 16:1059-1063.
• [10]Castaing D, Vibert E, Ricca L, et al.: Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg 2009, 250:849-855.
• [11]Abu Hilal M, Underwood T, Zuccaro M, et al.: Short- and medium-term results of totally laparoscopic resection for colorectal liver metastases. Br J Surg 2010, 97:927-933.
• [12]Cannon RM, Scoggins CR, Callender GG, et al.: Laparoscopic versus open resection of hepatic colorectal metastases. Surgery 2012, 152:567-573.
• [13]Cheung TT, Poon RT, Yuen WK, et al.: Outcome of laparoscopic versus open hepatectomy for colorectal liver metastases. ANZ J Surg 2012. Epub ahead of print
• [14]Topal H, Tiek J, Aerts R, et al.: Outcome of laparoscopic major liver resection for colorectal metastases. Surg Endosc 2012, 26:2451-2455.
• [15]Guerron AD, Aliyev S, Agcaoglu O, et al.: Laparoscopic versus open resection of colorectal liver metastasis. Surg Endosc 2013, 27:1138-1143.
• [16]Qiu J, Chen S, Pankaj P, et al.: Laparoscopic hepatectomy for hepatic colorectal metastases - a retrospective comparative cohort analysis and literature review. PLoS One 2013, 8:e60153.
• [17]Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group: Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009, 6:e1000097.
• [18]Hozo SP, Djulbegovic B, Hozo I: Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodo 2005, 5:13.
• [19]Athanasiou T, Al-Ruzzeh S, Kumar P, et al.: Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg 2004, 77:745-753.
• [20]Simillis C, Constantinides VA, Tekkis PP, et al.: Laparoscopic versus open hepatic resections for benign and malignant neoplasms–a meta-analysis. Surgery 2007, 141:203-211.
• [21]Croome KP, Yamashita MH: Laparoscopic vs open hepatic resection for benign and malignant tumors: An updated meta-analysis. Arch Surg 2010, 145:1109-1118.
• [22]Mirnezami R, Mirnezami AH, Chandrakumaran K, et al.: Short- and long-term outcomes after laparoscopic and open hepatic resection: systematic review and meta-analysis. HPB (Oxford) 2011, 13:295-308.
• [23]Kazaryan AM, Marangos IP, Røsok BI, et al.: Laparoscopic resection of colorectal liver metastases: surgical and long-term oncologic outcome. Ann Surg 2010, 252:1005-1012.
• [24]Wu WC, Smith TS, Henderson WG, et al.: Operative blood loss, blood transfusion, and 30-day mortality in older patients after major noncardiac surgery. Ann Surg 2010, 252:11-17.
• [25]Vanounou T, Steel JL, Nguyen KT, et al.: Comparing the clinical and economic impact of laparoscopic versus open liver resection . Ann Surg Oncol 2010, 17:998-1009.
• [26]Reza MM, Blasco JA, Andradas E, et al.: Systematic review of laparoscopic versus open surgery for colorectal cancer. Br J Surg 2006, 93:921-928.
• [27]Antoniou A, Lovegrove RE, Tilney HS, et al.: Meta-analysis of clinical outcome after first and second liver resection for colorectal metastases. Surgery 2007, 141:9-18.
• [28]Leung KL, Lee JF, Yiu RY, et al.: Simultaneous laparoscopic resection of rectal cancer and liver metastasis. J Laparoendosc Adv Surg Tech A 2006, 16:486-488.
• [29]Geiger TM, Tebb ZD, Sato E, et al.: Laparoscopic resection of colon cancer and synchronous liver metastasis. J Laparoendosc Adv Surg Tech A 2006, 16:5153.
• [30]Lupinacci RM, Machado MA, Lupinacci RA, et al.: Simultaneous left colectomy and standard hepatectomy reformed by laparoscopy. Rev Col Bras Cir 2011, 38:139-141.
• [31]Polignano FM, Quyn AJ, Sanjay P, et al.: Totally laparoscopic strategies for the management of colorectal cancer with synchronous liver metastasis. Surg Endosc 2012, 26:2571-2578.
• [32]Nguyen KT, Laurent A, Dagher I, et al.: Minimally invasive liver resection for metastatic colorectal cancer: a multi-institutional, international report of safety, feasibility, and early outcomes. Ann Surg 2009, 250:842-848.
• [33]Vigano L, Laurent A, Tayar C, et al.: The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 2009, 250:772-782.