AB038. SOH24AB_050. Comparing open, laparoscopic and robotic liver resection for metastatic colorectal cancer: a systematic review and network meta-analysis
Clinical Gastrointestinal Session

AB038. SOH24AB_050. Comparing open, laparoscopic and robotic liver resection for metastatic colorectal cancer: a systematic review and network meta-analysis

Luis Bouz Mkabaah1, Matthew Davey2, Eoin Kerin1, Odhran Ryan2, Gerry McEntee2,3, John Conneely2,3, Noel Donlon2,3

1Department of Surgery, The Lambe Institute for Translational Research, University of Galway, Galway, Ireland; 2Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland; 3Department of Hepatobiliary Surgery, Mater Misericordiae University Hospital, Dublin, Ireland

Background: The management of colorectal liver metastases (CRLMs) has evolved such that open liver resections (OLRs), laparoscopic liver resections (LLRs), and robotic liver resections (RLRs) are used for resection. This study aims to perform a network meta-analysis (NMA) comparing outcomes following OLR, LLR, and RLR for CRLM.

Methods: A NMA was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-NMA guidelines. Statistical analysis was performed using R packages and Shiny.

Results: A total of 13 studies involving 6,582 patients were included. Overall, 50.6% of patients underwent LLR (3,333/6,582), 45.3% underwent OLR (2,981/6,582), and 4.1% underwent RLR (268/6,582). At NMA, there was no significant difference observed in R0 resection rates following LLR [odds ratio (OR): 1.03, 95% confidence interval (CI): 0.84–1.26] and following RLR (OR: 1.57, 95% CI: 0.98–2.51) compared with OLR. Importantly, there was a non-significant difference observed at NMA for 1-year, 3-year, and 5-year disease-free survival (DFS) outcomes, with was a non-significant difference also observed for 1-year, 3-year and 5-year overall survival (OS). Overall, RLR (OR: 0.482, 95% CI: 0.240–0.916) and LLR (OR: 0.474, 95% CI: 0.302–0.714) reduced postoperative complication rates. Overall, patients undergoing LLR were more likely to convert to open (OR: 27.50, 95% CI: 7.73–97.48) versus those undergoing RLR (OR: 12.46, 95% CI: 2.64–58.67). There was a significant reduction in blood transfusions in favour of RLR (OR: 0.113, 95% CI: 0.036–0.360). Patients undergoing LLR had reduced hospital stay [mean difference (MD): −6.66, 95% CI: −11.6 to −1.88].

Conclusions: This study demonstrates the oncological safety of LLR and RLR in those with CRLM. The provision of well-designed randomised clinical trials is warranted to further ratify these results.

Keywords: Colorectal cancer liver metastasis; laparoscopic liver resection (LLR); open liver resection (OLR); robotic liver resection (RLR); surgical outcomes

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-24-ab038
Cite this abstract as: Bouz Mkabaah L, Davey M, Kerin E, Ryan O, McEntee G, Conneely J, Donlon N. AB038. SOH24AB_050. Comparing open, laparoscopic and robotic liver resection for metastatic colorectal cancer: a systematic review and network meta-analysis. Mesentery Peritoneum 2024;8:AB038.

Article Options

Download Citation

Share