Impact of type of liver resection on the outcome of colorectal liver metastases: a case-matched analysis |
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Authors: | Guzzetti Eleonora Pulitanò Carlo Catena Marco Arru Marcella Ratti Francesca Finazzi Renato Aldrighetti Luca Ferla Gianfranco |
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Affiliation: | Department of Surgery-Liver Unit, Scientific Institute H San Raffaele, Vita-Salute San Raffaele University, Milan, Italy. guzzetti.eleonora@hsr.it |
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Abstract: | BACKGROUND: Wedge resection (WR) for colorectal liver metastases (CLM) has become more common in an attempt to preserve liver parenchyma. However, some investigator have reported that WR is associated with a higher incidence of positive margin and an inferior survival compared with anatomic resection (AR) 1. OBJECTIVES: This study evaluated survival, margin status, and pattern of recurrence of patients with CLM treated with WR or AR. METHODS: We identified 208 consecutive patients, in a single institutional database from 1995 to 2004, who underwent either WR or AR. WR was defined as a nonanatomic resection and AR was defined as single resection of one or two liver segments. Patients with combined WR-AR and patients requiring resection of more than two segments or radiofrequency ablation were excluded from the analysis. RESULTS: One hundred six patients underwent WR and 102 patients had AR. There were no differences in the rate of positive surgical margin (P = 0.146), overall recurrence rates (P = 0.211), and patterns of recurrence between the two groups (P = 0.468). The median survival was 32 months for WR and 42 for AR, with 5-year survival rates of 29% and 27% respectively, with no significant difference (P = 0.308). Morbidity was similar between the two groups. CONCLUSIONS: WR is a safe procedure and does not disadvantage the patients in terms of tumor recurrence and overall survival. |
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Keywords: | liver surgery type of liver resection colorectal liver metastases anatomic resection wedge resection |
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