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Eur J Surg Oncol ; 40(5): 536-544, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24555996

RESUMO

AIMS: Liver resection is considered the standard treatment of colorectal metastases (CRLM). However, to date, no long term oncological results and data regarding repeat hepatectomy after laparoscopic approach are known. The aim of this study is to analyze single center long-term surgical and oncological outcomes after liver resection for CRLM. METHODS: A total of 57 open resections (OR) were matched with 57 laparoscopic resections (LR) for CRLM. Matching was based mainly on number of metastases, tumor size, segmental position of lesions, type of hepatectomy and type of resection. RESULTS: Morbidity rate was significantly less in the LR group (p = 0.002); the length of hospital stay was 6.5 ± 5 days for the LR group and 9.2 ± 4 days for the OR group (p = 0.005). After a median follow up of 53.7 months for the OR group and 40.9 months for the LR group, the 5-y overall survival rate was 65% and 60% respectively (p = 0.36) and the 5-y disease free survival rate was 38% and 29% respectively (p = 0.24). More patients in the LR group received a third hepatectomy for CRLM relapse than in the OR group (80% vs. 14.3% respectively; p = 0.015). CONCLUSIONS: Laparoscopic resection for CRLM offers advantages in terms of reduced blood loss, morbidity rate and hospital stay. It provides comparable long-term oncological outcomes but can improve further resectability in patients with recurrent disease.


Assuntos
Neoplasias Colorretais/patologia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Fígado/cirurgia , Recidiva Local de Neoplasia/cirurgia , Idoso , Estudos de Casos e Controles , Quimioterapia Adjuvante , Intervalo Livre de Doença , Feminino , Humanos , Laparoscopia/métodos , Tempo de Internação , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Recidiva Local de Neoplasia/secundário , Complicações Pós-Operatórias , Reoperação , Estudos Retrospectivos , Resultado do Tratamento
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