Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial

Davit L Aghayan; Åsmund A Fretland; Airazat M Kazaryan; Mushegh A Sahakyan; Vegar J Dagenborg; Bjørn Atle Bjørnbeth; Kjersti Flatmark; Ronny Kristiansen; Bjørn Edwin

doi:10.1016/j.hpb.2019.03.358

Laparoscopic versus open liver resection in the posterosuperior segments: a sub-group analysis from the OSLO-COMET randomized controlled trial

HPB (Oxford). 2019 Nov;21(11):1485-1490. doi: 10.1016/j.hpb.2019.03.358. Epub 2019 Apr 5.

Authors

Davit L Aghayan¹, Åsmund A Fretland², Airazat M Kazaryan³, Mushegh A Sahakyan⁴, Vegar J Dagenborg⁵, Bjørn Atle Bjørnbeth⁶, Kjersti Flatmark⁵, Ronny Kristiansen⁷, Bjørn Edwin²

Affiliations

¹ The Intervention Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway; Department of Surgery N1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia. Electronic address: [email protected].
² The Intervention Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway; Department of HPB Surgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
³ The Intervention Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Department of Surgery N1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia; Department of Surgery, Fonna Hospital Trust, Stord, Norway; Department of Faculty Surgery №2I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
⁴ The Intervention Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Department of Surgery N1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia; Department of General and Laparoscopic Surgery, Central Clinical Military Hospital, Yerevan, Armenia.
⁵ Institute of Clinical Medicine, Medical Faculty, University of Oslo, Norway; Department of Tumor Biology, Oslo University Hospital, Oslo, Norway; Department of Gastroenterological Surgery, Oslo University Hospital, Oslo, Norway.
⁶ Department of HPB Surgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
⁷ The Intervention Center, Oslo University Hospital - Rikshospitalet, Oslo, Norway; Department of Information Technology, Oslo University Hospital, Oslo, Norway.

PMID: 30962136
DOI: 10.1016/j.hpb.2019.03.358

Abstract

Background: Laparoscopic liver resection in the posterosuperior segments is technically challenging. This study aimed to compare the perioperative outcomes for laparoscopic and open resection of colorectal liver metastases located in the posterosuperior segments.

Methods: This was a subgroup analysis of the OSLO-COMET randomized controlled trial, where 280 patients were randomly assigned to open or laparoscopic parenchyma-sparing liver resections of colorectal metastases. Patients with tumors in the posterosuperior segments were identified, and perioperative outcomes and health related quality of life (HRQoL) were compared.

Results: We identified a total of 136 patients, 62 in the laparoscopic and 74 in the open group. The postoperative complication rate was 26% in the laparoscopic and 31% in the open group. The blood loss was less in the open group (500 vs. 250 ml, P = 0.006), but the perioperative transfusion rate was similar. The operative time was similar, while postoperative hospital stay was shorter in the laparoscopic group (2 vs. 4 days, P < 0.001). HRQoL was significantly better after laparoscopy at 1 month.

Conclusion: In patients undergoing laparoscopic or open liver resection of colorectal liver metastases in the posterosuperior segments, laparoscopic surgery was associated with shorter hospital stay and comparable perioperative outcomes.

Publication types

Comparative Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Blood Loss, Surgical / statistics & numerical data
Colorectal Neoplasms / pathology*
Female
Hepatectomy / methods*
Humans
Laparoscopy*
Length of Stay / statistics & numerical data
Liver Neoplasms / secondary*
Liver Neoplasms / surgery*
Male
Norway
Operative Time
Postoperative Complications
Quality of Life