Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany
Objective:. To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level. Background:. Colorectal cancer is the third most common malignancy worldwide. Up to 50% of all patients with colorectal...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2023-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000350 |
| _version_ | 1826858757921964032 |
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| author | Simon Moosburner, MD Chiara Kettler Karl H. Hillebrandt, MD Moritz Blank Hannes Freitag Sebastian Knitter, MD Felix Krenzien, MD Nora Nevermann, MD Igor M. Sauer, MD Dominik P. Modest, MD Georg Lurje, MD Robert Öllinger, MD Wenzel Schöning, MD Jens Werner, MD Maximilian Schmeding, MD Johann Pratschke, MD Nathanael Raschzok, MD members of StuDoQ|Liver of Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie/StuDoQ |
| author_facet | Simon Moosburner, MD Chiara Kettler Karl H. Hillebrandt, MD Moritz Blank Hannes Freitag Sebastian Knitter, MD Felix Krenzien, MD Nora Nevermann, MD Igor M. Sauer, MD Dominik P. Modest, MD Georg Lurje, MD Robert Öllinger, MD Wenzel Schöning, MD Jens Werner, MD Maximilian Schmeding, MD Johann Pratschke, MD Nathanael Raschzok, MD members of StuDoQ|Liver of Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie/StuDoQ |
| author_sort | Simon Moosburner, MD |
| collection | DOAJ |
| description | Objective:. To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level.
Background:. Colorectal cancer is the third most common malignancy worldwide. Up to 50% of all patients with colorectal cancer develop CRLM. MILS represents an attractive alternative to OLS for treatment of CRLM.
Methods:. Retrospective cohort study using the prospectively recorded German Quality management registry for liver surgery. Propensity-score matching was performed to account for variance in the extent of resection and patient demographics.
Results:. In total, 1037 patients underwent liver resection for CRLM from 2019 to 2021. MILS was performed in 31%. Operative time was significantly longer in MILS (234 vs 222 minutes, P = 0.02) compared with OLS. After MILS, median length of hospital stay (LOS) was significantly shorter (7 vs 10 days; P < 0.001). Despite 76% of major resections being OLS, postoperative complications and 90-day morbidity and mortality did not differ. The Pringle maneuver was more frequently used in MILS (48% vs 40%, P = 0.048). After propensity-score matching for age, body mass index, Eastern Cooperative Oncology Group, and extent of resection, LOS remained shorter in the MILS cohort (6 vs 10 days, P < 0.001) and operative time did not differ significantly (P = 0.2).
Conclusion:. MILS is not the standard for resection of CRLM in Germany. Drawbacks, such as a longer operative time remain. However, if technically possible, MILS is a reasonable alternative to OLS for resection of CRLM, with comparable postoperative complications, reduced LOS, and equal oncological radicality. |
| first_indexed | 2024-03-08T19:16:25Z |
| format | Article |
| id | doaj.art-568b6fc3243c4c029b550d82e9619bf9 |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2025-02-16T19:07:00Z |
| publishDate | 2023-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-568b6fc3243c4c029b550d82e9619bf92025-01-24T09:18:12ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932023-12-0144e35010.1097/AS9.0000000000000350202312000-00011Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in GermanySimon Moosburner, MD0Chiara Kettler1Karl H. Hillebrandt, MD2Moritz Blank3Hannes Freitag4Sebastian Knitter, MD5Felix Krenzien, MD6Nora Nevermann, MD7Igor M. Sauer, MD8Dominik P. Modest, MD9Georg Lurje, MD10Robert Öllinger, MD11Wenzel Schöning, MD12Jens Werner, MD13Maximilian Schmeding, MD14Johann Pratschke, MD15Nathanael Raschzok, MD16members of StuDoQ|Liver of Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie/StuDoQFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany‡ Department of Hematology, Oncology, and Cancer Immunology | CVKCharité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, BerlinFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany§ Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Hospital of the LMU Munich, Campus Großhadern, Munich‖ Department of Surgery, Clinic Dortmund gGmbH, Dortmund.From the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyFrom the * Department of Surgery, Experimental Surgery, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyObjective:. To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level. Background:. Colorectal cancer is the third most common malignancy worldwide. Up to 50% of all patients with colorectal cancer develop CRLM. MILS represents an attractive alternative to OLS for treatment of CRLM. Methods:. Retrospective cohort study using the prospectively recorded German Quality management registry for liver surgery. Propensity-score matching was performed to account for variance in the extent of resection and patient demographics. Results:. In total, 1037 patients underwent liver resection for CRLM from 2019 to 2021. MILS was performed in 31%. Operative time was significantly longer in MILS (234 vs 222 minutes, P = 0.02) compared with OLS. After MILS, median length of hospital stay (LOS) was significantly shorter (7 vs 10 days; P < 0.001). Despite 76% of major resections being OLS, postoperative complications and 90-day morbidity and mortality did not differ. The Pringle maneuver was more frequently used in MILS (48% vs 40%, P = 0.048). After propensity-score matching for age, body mass index, Eastern Cooperative Oncology Group, and extent of resection, LOS remained shorter in the MILS cohort (6 vs 10 days, P < 0.001) and operative time did not differ significantly (P = 0.2). Conclusion:. MILS is not the standard for resection of CRLM in Germany. Drawbacks, such as a longer operative time remain. However, if technically possible, MILS is a reasonable alternative to OLS for resection of CRLM, with comparable postoperative complications, reduced LOS, and equal oncological radicality.http://journals.lww.com/10.1097/AS9.0000000000000350 |
| spellingShingle | Simon Moosburner, MD Chiara Kettler Karl H. Hillebrandt, MD Moritz Blank Hannes Freitag Sebastian Knitter, MD Felix Krenzien, MD Nora Nevermann, MD Igor M. Sauer, MD Dominik P. Modest, MD Georg Lurje, MD Robert Öllinger, MD Wenzel Schöning, MD Jens Werner, MD Maximilian Schmeding, MD Johann Pratschke, MD Nathanael Raschzok, MD members of StuDoQ|Liver of Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie/StuDoQ Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany Annals of Surgery Open |
| title | Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany |
| title_full | Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany |
| title_fullStr | Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany |
| title_full_unstemmed | Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany |
| title_short | Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany |
| title_sort | minimal invasive versus open surgery for colorectal liver metastases a multicenter german studoq liver registry based cohort analysis in germany |
| url | http://journals.lww.com/10.1097/AS9.0000000000000350 |
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