Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial

Robles, R; López-López, Víctor; Brusadín, Roberto; López-Conesa, Asunción; Gil-Vazquez, Pedro José; Navarro-Barrios, Álvaro; Parrilla, Pascual

doi:10.1007/s00464-019-06679-0

Cited by 107 publications

(82 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In short‐term outcomes, postoperative morbidity and postoperative hospital stay were statistically significantly less after LLR than after OLR, whereas operative time, intraoperative blood loss, rate of blood transfusion, and mortality were equal between the two groups. Furthermore, the health‐related quality of life assessed by the Short Form 36 questionnaire was better in the LLR group for up to 4 months postoperatively; 65 importantly, there were no differences regarding OS and disease‐free survival (DFS) 64 …”

Section: Resultsmentioning

confidence: 96%

“…Two RCTs compared laparoscopic liver resection (LLR) with open liver resection (OLR) for CRLMs 63,64 . Note that most of the operative procedures in these RCTs were minor hepatectomies (Table 1); therefore, reliable evidence for MH is lacking.…”

Section: Resultsmentioning

confidence: 99%

“…Two RCTs compared laparoscopic liver resection (LLR) with open liver resection (OLR) for CRLMs. 63,64 Note that most of the operative procedures in these RCTs were minor hepatectomies (Table 1); therefore, reliable evidence for MH is lacking. In short-term outcomes, postoperative morbidity and postoperative hospital stay were statistically significantly less after LLR than after OLR, whereas operative time, intraoperative blood loss, rate of blood transfusion, and mortality were equal between the two groups.…”

Section: Recommendationmentioning

confidence: 99%

“…Furthermore, the health-related quality of life assessed by the Short Form 36 questionnaire was better in the LLR group for up to 4 months postoperatively; 65 importantly, there were no differences regarding OS and disease-free survival (DFS). 64 In addition to the RCTs, numerous non-RCT studies have been performed. However, many contained potential biases in terms of selection for tumor size, number of metastases, and location of the CRLMs.…”

Section: Recommendationmentioning

confidence: 99%

See 3 more Smart Citations

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Yamamoto

Yoshida

Furuse

et al. 2020

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

Background Hepatectomy is standard treatment for colorectal liver metastases; however, it is unclear whether liver metastases from other primary cancers should be resected or not. The Japanese Society of Hepato‐Biliary‐Pancreatic Surgery therefore created clinical practice guidelines for the management of metastatic liver tumors. Methods Eight primary diseases were selected based on the number of hepatectomies performed for each malignancy per year. Clinical questions were structured in the population, intervention, comparison, and outcomes (PICO) format. Systematic reviews were performed, and the strength of recommendations and the level of quality of evidence for each clinical question were discussed and determined. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations. Results The eight primary sites were grouped into five categories based on suggested indications for hepatectomy and consensus of the guidelines committee. Fourteen clinical questions were devised, covering five topics: (1) diagnosis, (2) operative treatment, (3) ablation therapy, (4) the eight primary diseases, and (5) systemic therapies. The grade of recommendation was strong for one clinical question and weak for the other 13 clinical questions. The quality of the evidence was moderate for two questions, low for 10, and very low for two. A flowchart was made to summarize the outcomes of the guidelines for the indications of hepatectomy and systemic therapy. Conclusions These guidelines were developed to provide useful information based on evidence in the published literature for the clinical management of liver metastases, and they could be helpful for conducting future clinical trials to provide higher‐quality evidence.

show abstract

Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Recommendationmentioning

confidence: 99%

Section: Recommendationmentioning

confidence: 99%

See 2 more Smart Citations

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Yamamoto

Yoshida

Furuse

et al. 2020

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

show abstract

“…In addition, oncological outcomes of overall survival (OS) and recurrence‐free survival (RFS) were similar between the MILR and OLR groups 25,26 . These results were subsequently supported by the LapOpHuva RCT that found MILR to be associated with lower morbidity and shorter duration of hospital stay, with no differences in OS and RFS as compared to OLR 27 . A summary of current evidence was presented in a meta‐analysis by Syn et al .…”

Section: Discussionmentioning

confidence: 89%

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Chin

Linn

Cheong

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background The utility of minimally‐invasive liver resection (MILR) for deep centrally located tumours (CLT) remains controversial. We aimed to review our institution's experience and outcomes with minimally invasive central hepatectomy (CH) and right anterior sectionectomy (RAS) for CLT in a propensity score‐matched (PSM) analysis. Methods Retrospective review of a prospectively maintained surgical database revealed 23 patients who underwent MILR (6 CH, 17 RAS) and 53 patients who underwent open liver resection (OLR; 24 CH, 29 RAS) for CLT. PSM in a 1:1 ratio identified two groups of patients with similar baseline clinicopathological characteristics. Peri‐operative outcomes were then compared. Results There was one laparoscopic‐assisted, one robot‐assisted and two laparoscopic‐converted‐open procedures in the MILR cohort. Across the unmatched cohort, there was only one mortality (MILR) and five patients with major morbidity (all OLR). MILR was associated with a longer operating time (P < 0.001), but shorter post‐operative hospital stay (P = 0.002) and decreased morbidity (P = 0.018) in the unmatched cohort. Examination of peri‐operative outcomes after PSM revealed that MILR was similarly associated with a longer operating time (P = 0.001) and shortened post‐operative hospital stay (P = 0.043). OLR was associated with a significantly reduced application of Pringle manoeuvre (P = 0.004). There were no significant differences between MILR and OLR with regards to blood loss, blood transfusions, morbidity and margin status in the PSM analysis. Conclusion MILR for CLT is safe and feasible when performed by experienced surgeons. It is associated with shorter hospital stays but at the expense of longer operation times and more frequent application of Pringle manoeuver.

show abstract

Optimizing Outcomes in Minimally Invasive Resections of Colorectal Liver Metastases

Mavani,

Shah

2024

JAMA Netw Open

View full text Add to dashboard Cite

Open versus minimally invasive liver surgery for colorectal liver metastases (LapOpHuva): a prospective randomized controlled trial

Cited by 107 publications

References 48 publications

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Minimally invasive versus open right anterior sectionectomy and central hepatectomy for central liver malignancies: a propensity‐score‐matched analysis

Optimizing Outcomes in Minimally Invasive Resections of Colorectal Liver Metastases

Contact Info

Product

Resources

About