Oncological Outcomes After Laparoscopic and Open Liver Resection in Patients with Colorectal Liver Metastases: A Single Centre Propensity Score Matched Study

Minimally invasive liver resections are widely used in hepatobiliary centres. This study compares oncological and survival outcomes between laparoscopic (LLR) and open liver resections (OLR) for colorectal liver metastases (CRLM) using propensity score matching (PSM). A retrospective single-centre study of patients undergoing liver resection for CRLM from January 2016 to December 2019 was conducted. Key co-variates were matched using PSM, and surgical and survival outcomes were compared before and after matching. Of 303 patients, 214 underwent OLR and 91 LLR. LLR was associated with shorter intensive treatment unit and inpatient stays, but with longer Pringle and operative times. In the unmatched cohort, LLR showed significantly better overall and disease-free survival. However, after PSM, while LLR showed reduced blood loss and shorter hospital stays, differences in survival outcomes were no longer significant, possibly due to the absence of bi-lobar disease in the laparoscopic group. In selected patients with CRLM, LLR demonstrates comparable long-term oncological and survival outcomes to OLR, as evidenced by our propensity score-matched analysis. This equivalence, combined with demonstrated advantages in short-term postoperative recovery, including reduced blood loss and shorter hospital stays, further supports a paradigm shift towards LLR as a standard approach for resectable CRLM. These findings emphasize the importance of patient selection and procedural expertise in achieving optimal outcomes.