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Perioperative and long-term outcomes of laparoscopic liver resections for non-colorectal liver metastases

Surgical Endoscopy Oct 13, 2019

Triantafyllidis I, et al. - Researchers performed a retrospective study of patients undergoing laparoscopic liver resection (LLR) for colorectal liver metastases (CRLMs) and non-colorectal liver metastases (NCRLMs) to determine their short- and long-term outcomes. From a prospectively maintained database between 2000 and 2018, they identified 354 (82.1%) patients with colorectal as the primary tumor, 21 (4.9%) with neuroendocrine as the primary tumor, and 56 (13%) patients with non-colorectal, non-neuroendocrine as the primary tumor. The major postoperative morbidities were reported in 12.7%, 19%, and 3.6%, respectively, whereas patients with CRLMs had a mortality of 0.6% and patients with NCRLMs had no mortality. Three- and 5-year overall survival rates in the CRLM group were 88.3% and 82.7%, in the NELM group were 85.7% and 70.6%, in the NCRNNELM group were 71.4% and 52.9%, respectively. Repeat LLR for recurrent metastatic tumors was undertaken in 113 out of 354 (31.9%) patients with CRLMs, 2 out of 21(9.5%) with NELMs, and 8 out of 56 (14.3%) patients with NCRNNELMs. Findings support the safety and feasibility of LLR in the context of multimodal management where an aggressive surgical approach, necessitating even complex procedures for bilobar multifocal metastases and repeat hepatectomy for recurrences, is the mainstay. Further, in selected patients with NCRNNELMs, LLR may be of benefit in long-term survival.
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