The Impact of Laparoscopic Approaches on Short-term Outcomes in Patients Undergoing Liver Surgery for Metastatic Tumors

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Georgios KaragkounisEren Berber

Abstract

To compare the perioperative outcomes associated with open and laparoscopic (LAP) surgical approaches for liver metastases. The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all adult patients who underwent surgical therapy for metastatic liver tumors between 2006 and 2012 (N=7684). Patients who underwent >1 procedure were excluded. Logistic regression after matching on propensity scores was used to assess the association between surgical approaches and perioperative outcomes. A total of 4555 patients underwent open resection, 387 LAP resection, 297 open radiofrequency ablation (RFA), and 265 LAP RFA. In propensity-matched samples (over 95% of patients successfully matched), there was no significant difference between LAP resection and LAP RFA in perioperative complications and length of stay and both compared favorably with their open counterparts. Minimally invasive approaches for secondary hepatic malignancies were associated with improved postoperative morbidity and length of stay and should be preferred in appropriate patients.

References

Mar 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Y FongM F Brennan
May 29, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Timothy M Pawlik, Michael A Choti
Jun 5, 2007·Journal of the American College of Surgeons·Shukri F KhuriUNKNOWN Principal Site Investigators of the Patient Safety in Surgery Study
Jun 5, 2007·Journal of the American College of Surgeons·Sophia ViraniKenneth K Tanabe
Aug 9, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Eren BerberAllan E Siperstein
Mar 6, 2009·Surgical Endoscopy·Andrea J RoweStephen W Chung
Oct 12, 2012·Surgical Endoscopy·Alfredo D GuerronEren Berber
Feb 28, 2014·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Li-Xi LuoYan-Nan Bai

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