Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments

Introduction: Laparoscopic liver resections (LLR) of colorectal metastasis located in posterosuperior segments (1, 4A, 7 and 8) are challenging and highly demanding. The aim of our study is to determine the safety and feasibility of hand-assisted laparoscopic surgery (HALS) in the resections of the...

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Autores principales:	Omar Abu-Zaydeh, Muneer Sawaied, Yael Berger, Ahmad Mahamid, Natalia Goldberg, Eran Sadot, Riad Haddad
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	metastatic colon cancer (mCRC) hand-assisted laparoscopic surgery (HALS) laparoscopic liver resection (LLR) posterosuperior segments open liver resection (OLR) Surgery RD1-811
Acceso en línea:	https://doaj.org/article/647ac720dc8c4af69151ed5f0ffb7969
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spelling	oai:doaj.org-article:647ac720dc8c4af69151ed5f0ffb79692021-11-30T21:24:41ZHand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments2296-875X10.3389/fsurg.2021.746427https://doaj.org/article/647ac720dc8c4af69151ed5f0ffb79692021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.746427/fullhttps://doaj.org/toc/2296-875XIntroduction: Laparoscopic liver resections (LLR) of colorectal metastasis located in posterosuperior segments (1, 4A, 7 and 8) are challenging and highly demanding. The aim of our study is to determine the safety and feasibility of hand-assisted laparoscopic surgery (HALS) in the resections of the posterosuperior lesions and to compare the peri-operative, short-term and long-term outcomes with the open liver resection (OLR) approach.Methods and Results: A retrospective study of patients who underwent either HALS or OLR for metastatic colorectal cancer (mCRC) located in the posterosuperior segments of the liver between 2008 and 2018 in two university affiliated medical centers.Results: A total of 187 patients were identified, of whom 78 underwent HALS and 109 underwent OLR. There was no difference between the HALS and OLR with regard to preoperative factors (age, primary CRC tumor location, number and anatomical distribution of liver metastasis, pre-operative neo-adjuvant treatment, operative time, blood transfusion rate, and resection margins positivity). On the other hand, HALS compared to OLR had a significantly shorter mean hospital stay (4 vs. 6 days; P = 0.003), and a lower total complications rate (25 vs. 47% P = 0.006). Both groups had no 30-day mortality. Also, patients who underwent HALS vs. OLR had similar liver metastases recurrence (55 vs. 51%. P = 0.65) and 5-year survival (47 vs. 45%. P = 0.72).Conclusions: HALS for mCRC located in posterosuperior liver segments is safe and feasible and it is a preferable approach due to its lower complication rate and shorter hospital stay while not compromising survival and disease recurrence.Omar Abu-ZaydehMuneer SawaiedYael BergerYael BergerAhmad MahamidAhmad MahamidNatalia GoldbergNatalia GoldbergEran SadotEran SadotRiad HaddadRiad HaddadFrontiers Media S.A.articlemetastatic colon cancer (mCRC)hand-assisted laparoscopic surgery (HALS)laparoscopic liver resection (LLR)posterosuperior segmentsopen liver resection (OLR)SurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	metastatic colon cancer (mCRC) hand-assisted laparoscopic surgery (HALS) laparoscopic liver resection (LLR) posterosuperior segments open liver resection (OLR) Surgery RD1-811
spellingShingle	metastatic colon cancer (mCRC) hand-assisted laparoscopic surgery (HALS) laparoscopic liver resection (LLR) posterosuperior segments open liver resection (OLR) Surgery RD1-811 Omar Abu-Zaydeh Muneer Sawaied Yael Berger Yael Berger Ahmad Mahamid Ahmad Mahamid Natalia Goldberg Natalia Goldberg Eran Sadot Eran Sadot Riad Haddad Riad Haddad Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
description	Introduction: Laparoscopic liver resections (LLR) of colorectal metastasis located in posterosuperior segments (1, 4A, 7 and 8) are challenging and highly demanding. The aim of our study is to determine the safety and feasibility of hand-assisted laparoscopic surgery (HALS) in the resections of the posterosuperior lesions and to compare the peri-operative, short-term and long-term outcomes with the open liver resection (OLR) approach.Methods and Results: A retrospective study of patients who underwent either HALS or OLR for metastatic colorectal cancer (mCRC) located in the posterosuperior segments of the liver between 2008 and 2018 in two university affiliated medical centers.Results: A total of 187 patients were identified, of whom 78 underwent HALS and 109 underwent OLR. There was no difference between the HALS and OLR with regard to preoperative factors (age, primary CRC tumor location, number and anatomical distribution of liver metastasis, pre-operative neo-adjuvant treatment, operative time, blood transfusion rate, and resection margins positivity). On the other hand, HALS compared to OLR had a significantly shorter mean hospital stay (4 vs. 6 days; P = 0.003), and a lower total complications rate (25 vs. 47% P = 0.006). Both groups had no 30-day mortality. Also, patients who underwent HALS vs. OLR had similar liver metastases recurrence (55 vs. 51%. P = 0.65) and 5-year survival (47 vs. 45%. P = 0.72).Conclusions: HALS for mCRC located in posterosuperior liver segments is safe and feasible and it is a preferable approach due to its lower complication rate and shorter hospital stay while not compromising survival and disease recurrence.
format	article
author	Omar Abu-Zaydeh Muneer Sawaied Yael Berger Yael Berger Ahmad Mahamid Ahmad Mahamid Natalia Goldberg Natalia Goldberg Eran Sadot Eran Sadot Riad Haddad Riad Haddad
author_facet	Omar Abu-Zaydeh Muneer Sawaied Yael Berger Yael Berger Ahmad Mahamid Ahmad Mahamid Natalia Goldberg Natalia Goldberg Eran Sadot Eran Sadot Riad Haddad Riad Haddad
author_sort	Omar Abu-Zaydeh
title	Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
title_short	Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
title_full	Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
title_fullStr	Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
title_full_unstemmed	Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments
title_sort	hand-assisted laparoscopic surgery is superior to open liver resection for colorectal liver metastases in the posterosuperior segments
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/647ac720dc8c4af69151ed5f0ffb7969
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Hand-Assisted Laparoscopic Surgery Is Superior to Open Liver Resection for Colorectal Liver Metastases in the Posterosuperior Segments

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