title: Outcome of laparoscopic major liver resection for colorectal metastases.
abstract: BACKGROUND
  Minimally invasive liver resection (MILR) for colorectal liver metastases (CRLM) is gaining widespread acceptance. However, data are still lacking on the feasibility, long- and short-term outcomes of laparoscopic major hepatectomy (i.e., three or more liver segments).
  
  
  METHODS
  Between October 2002 and December 2008, prospectively collected data of 117 patients who underwent major liver resection [97 open (OMLR) and 20 laparoscopic (LMLR) procedures] for CRLM were analyzed. Twenty patients in the LMLR group were matched with 20 patients of the OMLR based on 13 parameters. We compared the long- and short-term outcomes between these two groups.
  
  
  RESULTS
  Median duration of surgery was 257.5 (range 75-360) min in LMLR versus 232.5 (range 120-400) min in OMLR (P = 0.228). Median blood loss during surgery was 550 ml in each group (range 100-4,000 vs. 100-2,500 ml, P = 0.884). There was no statistically significant difference in the rate of postoperative complications (both severity and location). Median magnitude of tumor-free resection margin was 7.5 versus 5.5 mm in the laparoscopy versus open group, respectively (P = 0.651). Median disease-free survival (DFS) of the entire study population was 18.4 months [95% confidence interval (CI) 11.9-50.0 months]. Median overall survival (OS) was 50.7 months (95% CI 36.2 months to undetermined). The estimated DFS and OS rates at 1, 2, and 5 years were comparable in the two groups (P = 0.637 and 0.872, respectively).
  
  
  CONCLUSIONS
  Laparoscopic MLR for selected CRLM is feasible and might result in comparable oncologic outcomes as in open liver resection.
authors.affiliation: Department of Abdominal Surgery, University Hospitals Leuven KUL, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Halit
authors.initials: H
authors.lastname: Topal
authors.forename: Joyce
authors.initials: J
authors.lastname: Tiek
authors.forename: Raymond
authors.initials: R
authors.lastname: Aerts
authors.forename: Baki
authors.initials: B
authors.lastname: Topal
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome