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Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: a propensity score matching analysis.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2016 Sep; Vol. 18 (9), pp. 781-90. Date of Electronic Publication: 2016 Jul 05. - Publication Year :
- 2016
-
Abstract
- Objective: The aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM).<br />Background: The surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver. Two approaches are adaptable as follows: parenchymal-sparing hepatectomies (PSH) and extended hepatectomies (NON-PSH).<br />Methods: A total of 3036 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched in a 1:1 propensity score analysis in order to compare PSH versus NON-PSH resections.<br />Results: PSH was associated with a lower number of complications (≥1) (25% vs. 34%, p = 0.04) and a lower grade of Dindo-Clavien III and IV (10 vs. 16%, p = 0.03). Liver failure was less present in PSH (2 vs. 7%, p = 0.006), with a shorter ICU stay (0 day vs. 1 day, p = 0.004). No differences were demonstrated in overall and disease-free survival.<br />Conclusion: In conclusion, PSH resection for bilobar multiple CLMs represents a valid alternative to NON-PSH resection in selected patients with a reduced morbidity and comparable oncological results.<br /> (Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Chi-Square Distribution
Disease-Free Survival
Female
France
Hepatectomy adverse effects
Hepatectomy mortality
Humans
Kaplan-Meier Estimate
Length of Stay
Liver Failure etiology
Liver Neoplasms mortality
Liver Neoplasms secondary
Logistic Models
Male
Middle Aged
Propensity Score
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Colorectal Neoplasms pathology
Hepatectomy methods
Liver Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 18
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 27593596
- Full Text :
- https://doi.org/10.1016/j.hpb.2016.06.004