Laparoscopic parenchyma-sparing surgery in the treatment of colorectal liver metastases

Abstract

Traditionally, open anatomical resections had been accepted as a gold standard in the treatment of colorectal liver metastases. Recently, parenchyma-sparing strategy has shown its advantages in both open and laparoscopic liver surgery. Despite that laparoscopic approach has been adopted by many specialized centres, there is a lack of sufficient evidence on laparoscopic liver surgery. This thesis aimed to investigate the role of laparoscopic parenchyma-sparing surgery in the treatment of colorectal liver metastases by highlighting its surgical and oncologic results, and comparing with conventional open approach in a randomized controlled trial. Laparoscopic parenchyma-sparing resection in patients with colorectal liver metastases was associated with satisfactory surgical and oncological outcomes, also in patients with multiple metastases. Laparoscopic resection in the postero-superior liver segments is a rational alternative to open approach providing shorter hospital stay, enhanced recovery and better health-related quality of life. In a randomized setting, laparoscopic approach was shown to be as good as open approach in terms of long-term oncologic outcomes.