Does laparoscopic liver resection for colorectal liver metastases provide a true survival benefit compared with open liver resection?

Shinichi Akahoshi, Toru Beppu, Yasuhisa Mori, Koichi Kinoshita, Nobutaka Sato, Ken Kikuchi


The recent Southampton consensus guideline and two previous international consensus meetings held in Louisville and Morioka in 2008 and 2014, respectively have recommended laparoscopic liver resection (LLR) as a standard procedure for selected patients with colorectal liver metastases (CRLM) (1-3). The Oslo-CoMet and LapOpHuva studies are the only two randomized controlled trials (RCTs) that have provided solid evidence showing that LLR is a safer, less invasive, and more cost- effective approach with higher health-related quality of life and oncological outcomes equivalent to those of open liver resection (OLR) for patients with CRLM (4-6). Many cohort studies that used propensity score matching (PSM) and their meta-analyses have demonstrated decreased intraoperative blood loss, blood transfusion rate, and morbidity; shorter hospital stays; and improved postoperative quality of life in LLR patient groups than in OLR groups (7-9). Additionally, long-term outcomes have been found to be comparable between these two treatment groups.