Laparoscopic parenchyma-sparing surgery in the treatment of colorectal liver metastases
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AbstractTraditionally, 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.
List of papers
|Paper I. Aghayan D L, Pelanis E, Fretland Å A, Kazaryan A M, Sahakyan M A, Røsok B I, Barkhatov L I, Bjørnbeth B A, Elle O J and Edwin, B. Laparoscopic Parenchyma-Sparing Liver Resection for Colorectal Metastases. Radiology and Oncology. 2017 Nov 1;52(1):36-41. DOI: 10.1515/raon-2017-0046. The article is included in the thesis. Also available at: https://doi.org/10.1515/raon-2017-0046|
|Paper II. Kazaryan, A M, Aghayan D L, Barkhatov L I, Fretland Å A and Edwin B. Laparoscopic Multiple Parenchyma-sparing Concomitant Liver Resections for Colorectal Liver Metastases. Surgical laparoscopy, endoscopy & percutaneous techniques. 2019 Jun;29(3):187-193. DOI: 10.1097/SLE.0000000000000606. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1097/SLE.0000000000000606|
|Paper III. Aghayan D L, Fretland Å A, Kazaryan A M, Sahakyan M A, Dagenborg V J, Bjørnbeth B A, Flatmark K, Kristiansen R, Edwin B. Laparoscopic versus open liver resection in the posterosuperior segments: a subgroup analysis from the OSLO-COMET randomized controlled trial. HPB (Oxford). 2019 Nov;21(11):1485-1490. DOI: 10.1016/j.hpb.2019.03.358. The article is not available in DUO due to publisher restrictions. The published version is available at: https://doi.org/10.1016/j.hpb.2019.03.358|
|Paper IV. Aghayan D L, Kazaryan A M, Dagenborg V J, Røsok B I, Fagerland M W, Bjørnelv G M, Kristiansen R, Flatmark K, Fretland Å A, Edwin B. Long-term oncological outcomes after laparoscopic versus open resection for colorectal liver metastases. Ann Intern Med. [Epub ahead of print 17 November 2020]. doi:10.7326/M20-4011. The paper is included in the thesis. Also available at: https://doi.org/10.7326/M20-4011|