There is a lack of consensus in literature about the impact of primary tumor location on survival rates for patients with colorectal liver metastases (CRLM), especially as most studies are based in Western populations.
A study conducted on 501 patients in Israel categorized tumors as right-sided or left-sided, finding that right-sided patients were older but left-sided patients had slightly better survival rates, though these differences weren't statistically significant.
Ultimately, the research suggests that in the Mediterranean population, the location of the primary tumor does not significantly influence survival after liver resection for CRLM.
Hand-assisted laparoscopic surgery (HALS) is considered a safe option for removing metastatic liver disease, particularly in older patients over 75, but data on its effectiveness in this age group is limited.
A study compared outcomes of patients over 75 (group 1) with those under 75 (group 2), noting differences in tumor location, surgical approach, and completion rates of pre-surgery therapy.
Findings showed that while HALS was effective for elderly patients, they experienced a slightly higher complication rate and lower 5-year survival rate compared to younger patients, indicating that it remains a viable option for treating colorectal liver metastasis in older adults.
Hand-assisted laparoscopic surgery for liver resection is a common procedure, and this study focuses on the risk of postoperative incisional hernia (IH) in patients undergoing this surgery for colorectal liver metastasis.
A retrospective analysis of 89 patients showed an 18% complication rate, with 7.8% developing IH at the hand port site, particularly in those who were overweight (BMI ≥ 25) and in patients undergoing simultaneous liver and colon resection.
Factors identified as independent risks for incisional hernia include the simultaneous resection of liver and colon and a platelet-to-lymphocyte ratio of ≤ 200.
Laparoscopic liver resections (LLR) for colorectal metastasis in the difficult posterosuperior segments are challenging, prompting a study to assess the safety and effectiveness of hand-assisted laparoscopic surgery (HALS) compared to open liver resection (OLR).
A total of 187 patients were analyzed, with 78 undergoing HALS and 109 OLR, showing no significant preoperative differences between the groups.
HALS led to a shorter hospital stay and lower complication rates compared to OLR, while survival rates and recurrence of liver metastases were similar for both surgical approaches.
The study compares the short-term and long-term outcomes of laparoscopic versus open colorectal resection in patients with metastatic colorectal cancer and liver metastases.
A total of 63 patients were analyzed, showing that laparoscopic surgery had longer operative times but shorter hospital stays compared to open surgery.
The findings suggest that laparoscopic methods are safer and yield better short-term outcomes without compromising survival rates.
Hand-assisted laparoscopic repeat hepatectomy (HALRH) is a promising alternative to traditional open surgery for patients undergoing repeat liver resection, showing a low conversion rate to open surgery.
The study included 16 patients, primarily elderly, with a high success rate (88%) for complete tumor removal and no major post-surgical complications.
As HALRH proved safe and effective, it should be considered in future guidelines for enhanced recovery after surgery (ERAS) in liver procedures.