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Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial.
Robles-Campos, Ricardo; Lopez-Lopez, Víctor; Brusadin, Roberto; Lopez-Conesa, Asunción; Gil-Vazquez, Pedro José; Navarro-Barrios, Álvaro; Parrilla, Pascual.
Afiliación
  • Robles-Campos R; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain. rirocam@um.es.
  • Lopez-Lopez V; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
  • Brusadin R; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
  • Lopez-Conesa A; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
  • Gil-Vazquez PJ; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
  • Navarro-Barrios Á; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
  • Parrilla P; Department of Liver Surgery and Transplantation, Virgen de la Arrixaca Clinic and University Hospital, IMIB, El Palmar, Murcia, Spain.
Surg Endosc ; 33(12): 3926-3936, 2019 12.
Article en En | MEDLINE | ID: mdl-30701365
OBJECTIVE: To present surgical and oncological outcomes using a prospective and randomized trial (LapOpHuva, NCT02727179) comparing minimally invasive liver resection (LLR) versus open liver resection (OLR) in patients with colorectal liver metastases (CRLM). METHODS: Between February 2005 and March 2016, 204 selected patients with CRLM were randomized and 193 were included: LLR (n = 96) and OLR (n = 97). The primary endpoint was to compare postoperative morbidity. Other secondary endpoints were oncological outcomes, use of the Pringle maneuver, surgical time, blood losses, transfusions, hospital stay, mortality and OS, and disease-free survival (DFS) at 3, 5, and 7 years. RESULTS: LLR presented with lower global morbidity (11.5% vs. 23.7%, p = 0.025) but with similar severe complications. Long-term survival outcomes were similar in both groups. The cumulative 1-, 3-, 5-, 7-year OS for LLR and OLR were 92.5%, 71.5%, 49.3%, 35.6% versus 93.6%, 69.7%, 47.4%, 35.5%, respectively (log-rank = 0.047, p = 0.82). DFS for LLR and OLR was 72.7%, 33.5%, 22.7%, and 20.8% versus 61.6%, 27.2%, 23.9%, and 17.9%, respectively (log-rank = 1.427, p = 0.23). LLR involved more use of the Pringle maneuver (15.5% vs. 30.2%, p = 0.025) and a shorter hospital stay (4 vs. 6 days, p < 0.001). There were no differences regarding surgical time, blood losses, transfusion, and mortality. CONCLUSIONS: In selected patients with CRLM, LLR presents similar oncological outcomes with the advantages of the short-term results associated with LLR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía / Hepatectomía / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article País de afiliación: España Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía / Hepatectomía / Neoplasias Hepáticas Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Surg Endosc Asunto de la revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Año: 2019 Tipo del documento: Article País de afiliación: España Pais de publicación: Alemania