Long-term oncological outcomes for HALS/Hybrid vs pure laparoscopic approach in colorectal liver metastases: a propensity score matched analysis

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art_LOPEZ-LOPEZ_Longterm_oncological_outcomes_for_HALSHybrid_vs_pure_laparoscopic_2023.PDF (1.28 MB)
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SPRINGER
Autores
LOPEZ-LOPEZ, Victor
KUEMMERLI, Christopher
TOHME, Samer
GOMEZ-GAVARA, Concepcion
INIESTA, Maria
LOPEZ-CONESA, Asuncion
DOGEAS, Epameinondas
DALMAU, Mar
BRUSADIN, Roberto
Citação
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.37, n.5, p.3861-3872, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BackgroundStudies comparing hand-assisted laparoscopic (HALS)/Hybrid and pure laparoscopic (PLS) resection for colorectal cancer liver metastasis have focused on short-term results, while long-term oncological outcomes remain understudied.MethodsWe established a multi-institutional retrospective cohort study from four centers with experience in minimally invasive surgery between 2004 and 2020. Primary endpoints were overall survival (OS) and disease-free survival (DFS). Other endpoints analyzed were intraoperative and postoperative outcomes. Propensity score matching (PSM) was used to minimize baseline differences.ResultsA total of 219 HALS/Hybrid (57.8%) and 160 PLS (42.2%) patients were included. After PSM, 155 patients remained in each group. Operative time (182 vs. 248 min, p = 0.012), use of intraoperative ablation (12.3 vs. 4.5%, p = 0.024), positive resection margin (4.5 vs 13.2%, p = 0.012), and pringle time (21 vs. 37 min, p = 0.001) were higher in PLS group. DFS at 1, 3, 5, and 7 years in HALS/Hybrid and PLS groups were 65.4%, 39.3%, 37.5%, and 36.3% vs. 64.9%, 38.0%, 33.1%, and 33.1%, respectively (p = 0.84). OS at 1, 3, 5, and 7 years in HALS/Hybrid and PLS groups were 94.5%, 71.4%, 54.3%, and 46.0% vs. 96.0%, 68.5%, 51.2%, and 41.2%, respectively (p = 0.73).ConclusionOur study suggests no differences in long-term oncologic outcomes between the two techniques. We discovered that longer total operative, pringle time, higher rates of intraoperative ablation, and positive resection margins were associated with PLS. These differences in favor of HALS/Hybrid could be due to a shorter learning curve and a greater ability to control hemorrhage.
Palavras-chave
Colorectal liver mestastases, Pure laparoscopy, Hand-assisted, Short-term outcomes, Oncological outcomes
URI
https://observatorio.fm.usp.br/handle/OPI/53913
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/37
Artigos e Materiais de Revistas Científicas - ODS/03