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Moosburner, Simon; Kettler, Chiara; Hillebrandt, Karl H.; Blank, Moritz; Freitag, Hannes; Knitter, Sebastian; Krenzien, Felix; Nevermann, Nora; Sauer, Igor M.; Modest, Dominik P.; Lurje, Georg; Öllinger, Robert; Schöning, Wenzel; Werner, Jens; Schmeding, Maximilian; Pratschke, Johann; Raschzok, Nathanael

Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany

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  • Media type: E-Article
  • Title: Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany
  • Contributor: Moosburner, Simon; Kettler, Chiara; Hillebrandt, Karl H.; Blank, Moritz; Freitag, Hannes; Knitter, Sebastian; Krenzien, Felix; Nevermann, Nora; Sauer, Igor M.; Modest, Dominik P.; Lurje, Georg; Öllinger, Robert; Schöning, Wenzel; Werner, Jens; Schmeding, Maximilian; Pratschke, Johann; Raschzok, Nathanael
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2023
  • Published in: Annals of Surgery Open
  • Language: English
  • DOI: 10.1097/as9.0000000000000350
  • ISSN: 2691-3593
  • Keywords: General Earth and Planetary Sciences
  • Origination:
  • Footnote:
  • Description: <jats:sec> <jats:title>Objective:</jats:title> <jats:p>To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level.</jats:p> </jats:sec> <jats:sec> <jats:title>Background:</jats:title> <jats:p>Colorectal cancer is the third most common malignancy worldwide. Up to 50% of all patients with colorectal cancer develop CRLM. MILS represents an attractive alternative to OLS for treatment of CRLM.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>Retrospective cohort study using the prospectively recorded German Quality management registry for liver surgery. Propensity-score matching was performed to account for variance in the extent of resection and patient demographics.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>In total, 1037 patients underwent liver resection for CRLM from 2019 to 2021. MILS was performed in 31%. Operative time was significantly longer in MILS (234 <jats:italic toggle="yes">vs</jats:italic> 222 minutes, <jats:italic toggle="yes">P</jats:italic> = 0.02) compared with OLS. After MILS, median length of hospital stay (LOS) was significantly shorter (7 <jats:italic toggle="yes">vs</jats:italic> 10 days; <jats:italic toggle="yes">P</jats:italic> &lt; 0.001). Despite 76% of major resections being OLS, postoperative complications and 90-day morbidity and mortality did not differ. The Pringle maneuver was more frequently used in MILS (48% <jats:italic toggle="yes">vs</jats:italic> 40%, <jats:italic toggle="yes">P</jats:italic> = 0.048). After propensity-score matching for age, body mass index, Eastern Cooperative Oncology Group, and extent of resection, LOS remained shorter in the MILS cohort (6 <jats:italic toggle="yes">vs</jats:italic> 10 days, <jats:italic toggle="yes">P</jats:italic> &lt; 0.001) and operative time did not differ significantly (<jats:italic toggle="yes">P</jats:italic> = 0.2).</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion:</jats:title> <jats:p>MILS is not the standard for resection of CRLM in Germany. Drawbacks, such as a longer operative time remain. However, if technically possible, MILS is a reasonable alternative to OLS for resection of CRLM, with comparable postoperative complications, reduced LOS, and equal oncological radicality.</jats:p> </jats:sec>
  • Access State: Open Access