Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Oncological Outcomes after Laparoscopic and Open Liver Resection in patients with Colorectal Liver Metastases: A Single Centre Propensity Score Matched Study

Alberto Diaz-Garcia
,
Alex Gordon-Weeks
ORCID logo ,
Robert Young
,
Timothy Gilbert
,
Adeeb Rehman
,
Hassan Malik
,
Stephen Fenwick
,
Robert P Jones
,
Rafael Diaz-Nieto
*
Version 1 : Received: 23 May 2023 / Approved: 25 May 2023 / Online: 25 May 2023 (05:14:42 CEST)

How to cite: Diaz-Garcia, A.; Gordon-Weeks, A.; Young, R.; Gilbert, T.; Rehman, A.; Malik, H.; Fenwick, S.; Jones, R. P.; Diaz-Nieto, R. Oncological Outcomes after Laparoscopic and Open Liver Resection in patients with Colorectal Liver Metastases: A Single Centre Propensity Score Matched Study. Preprints 2023, 2023051737. https://doi.org/10.20944/preprints202305.1737.v1 Diaz-Garcia, A.; Gordon-Weeks, A.; Young, R.; Gilbert, T.; Rehman, A.; Malik, H.; Fenwick, S.; Jones, R. P.; Diaz-Nieto, R. Oncological Outcomes after Laparoscopic and Open Liver Resection in patients with Colorectal Liver Metastases: A Single Centre Propensity Score Matched Study. Preprints 2023, 2023051737. https://doi.org/10.20944/preprints202305.1737.v1

Abstract

Abstract Introduction Minimally invasive approaches to oncological liver resection is common in many hepatobiliary centres. This study aims to compare the key oncological and survival outcomes of patients with colorectal liver metastases (CRLM) undergoing laparoscopic or open resections using propensity score matching (PSM). Methods A single-centre retrospective study was performed using a prospective database of patients undergoing liver resection for CRLM between January 2016 and December 2019. Different co-variates were selected for matching using PSM. Pre-matching and post-matching analyses were compared. Surgical and survival outcomes were analysed. Results In total, 303 patients who met the inclusion criteria were identified: 214 underwent open liver resection (OLR) and 91 laparoscopic liver resection (LLR). LLR had a significantly reduced length of intensive treatment unit (ITU) and overall in-patient stay but longer pringle and operative times. In the unmatched cohort, the median overall and disease-free survival time was significantly longer in patients undergoing laparoscopic compared with open surgery. A PSM model demonstrated significantly reduced blood loss and length of hospital stay, with a significantly greater Pringle and operative time in the LLR group. Differences seen in overall and disease-free survival were lost with propensity score matching, possibly due to lack of bi-lobar disease within the minimally invasive group. Conclusion In selected patients with CRLM, LLR presents similar survival and oncological outcomes with the advantages of the short-term results associated with the laparoscopic approach.

Keywords

liver surgery; colorectal cancer; laparoscopy; survival

Subject

Medicine and Pharmacology, Surgery

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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