Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

Abstract The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary end...

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Autores principales:	Si-Ming Xie, Jun-Jie Xiong, Xue-Ting Liu, Hong-Yu Chen, Daniel Iglesia-García, Kiran Altaf, Shameena Bharucha, Wei Huang, Quentin M. Nunes, Peter Szatmary, Xu-Bao Liu
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b17818777ef94ff782f3f1604d7f4997
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spelling	oai:doaj.org-article:b17818777ef94ff782f3f1604d7f49972021-12-02T11:53:01ZLaparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis10.1038/s41598-017-00978-z2045-2322https://doaj.org/article/b17818777ef94ff782f3f1604d7f49972017-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-00978-zhttps://doaj.org/toc/2045-2322Abstract The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary endpoints were oncological outcomes. In total, 32 eligible non-randomized studies with 4697 patients (LLR: 1809, OLR: 2888) were analyzed. There were higher rates of clear surgical margins (OR: 1.64, 95%CI: 1.32 to 2.05, p < 0.00001) in the LLR group, without significant differences in disease recurrence, 3- or 5-year overall survival(OS) and disease free survival(DFS) between the two approaches. LLR was associated with less intraoperative blood loss (WMD: −147.46 [−195.78 to −99.15] mL, P < 0.00001) and fewer blood transfusions (OR: 0.41 [0.30–0.58], P < 0.00001), but with longer operation time (WMD:14.44 [1.01 to 27.88] min, P < 0.00001) compared to OLR. Less overall morbidity (OR: 0.64 [0.55 to 0.75], p < 0.00001) and shorter postoperative hospital stay (WMD: −2.36 [−3.06 to −1.66] d, p < 0.00001) were observed for patients undergoing LLR, while there was no statistical difference in mortality. LLR appears to be a safe and feasible alternative to OLR in the treatment of CCLM in selected patients.Si-Ming XieJun-Jie XiongXue-Ting LiuHong-Yu ChenDaniel Iglesia-GarcíaKiran AltafShameena BharuchaWei HuangQuentin M. NunesPeter SzatmaryXu-Bao LiuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-10 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Si-Ming Xie Jun-Jie Xiong Xue-Ting Liu Hong-Yu Chen Daniel Iglesia-García Kiran Altaf Shameena Bharucha Wei Huang Quentin M. Nunes Peter Szatmary Xu-Bao Liu Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
description	Abstract The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary endpoints were oncological outcomes. In total, 32 eligible non-randomized studies with 4697 patients (LLR: 1809, OLR: 2888) were analyzed. There were higher rates of clear surgical margins (OR: 1.64, 95%CI: 1.32 to 2.05, p < 0.00001) in the LLR group, without significant differences in disease recurrence, 3- or 5-year overall survival(OS) and disease free survival(DFS) between the two approaches. LLR was associated with less intraoperative blood loss (WMD: −147.46 [−195.78 to −99.15] mL, P < 0.00001) and fewer blood transfusions (OR: 0.41 [0.30–0.58], P < 0.00001), but with longer operation time (WMD:14.44 [1.01 to 27.88] min, P < 0.00001) compared to OLR. Less overall morbidity (OR: 0.64 [0.55 to 0.75], p < 0.00001) and shorter postoperative hospital stay (WMD: −2.36 [−3.06 to −1.66] d, p < 0.00001) were observed for patients undergoing LLR, while there was no statistical difference in mortality. LLR appears to be a safe and feasible alternative to OLR in the treatment of CCLM in selected patients.
format	article
author	Si-Ming Xie Jun-Jie Xiong Xue-Ting Liu Hong-Yu Chen Daniel Iglesia-García Kiran Altaf Shameena Bharucha Wei Huang Quentin M. Nunes Peter Szatmary Xu-Bao Liu
author_facet	Si-Ming Xie Jun-Jie Xiong Xue-Ting Liu Hong-Yu Chen Daniel Iglesia-García Kiran Altaf Shameena Bharucha Wei Huang Quentin M. Nunes Peter Szatmary Xu-Bao Liu
author_sort	Si-Ming Xie
title	Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
title_short	Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
title_full	Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
title_fullStr	Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
title_full_unstemmed	Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis
title_sort	laparoscopic versus open liver resection for colorectal liver metastases: a comprehensive systematic review and meta-analysis
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/b17818777ef94ff782f3f1604d7f4997
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Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

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