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  1. Article ; Online: Simplifying minimally invasive right hepatectomy.

    Nevermann, Nora / Feldbrügge, Linda / Knitter, Sebastian / Krenzien, Felix / Raschzok, Nathanael / Lurje, Georg / Schöning, Wenzel / Pratschke, Johann / Schmelzle, Moritz

    Surgical endoscopy

    2023  Volume 37, Issue 7, Page(s) 5430–5437

    Abstract: Background: Extrahepatic transection of the right hepatic artery and right portal vein before parenchymal dissection is a widely used standard for minimal invasive right hepatectomy. Hereby, hilar dissection represents a technical difficulty. We report ... ...

    Abstract Background: Extrahepatic transection of the right hepatic artery and right portal vein before parenchymal dissection is a widely used standard for minimal invasive right hepatectomy. Hereby, hilar dissection represents a technical difficulty. We report our results of a simplified approach in which the hilar dissection is omitted and the line of dissection is defined with ultrasound.
    Methods: Patients undergoing minimally invasive right hepatectomy were included. Ultrasound-guided hepatectomy (UGH) was defined by the following main steps: (1) ultrasound-guided definition of the transection line, (2) dissection of the liver parenchyma according to the caudal approach, (3) intraparenchymal transection of the right pedicle and (4) of the right liver vein, respectively. Intra- and postoperative outcomes of UGH were compared to the standard technique. Propensity score matching was performed to adjust for parameters of perioperative risk.
    Results: Median operative time was 310 min in the UGH group compared to 338 min in the control group (p = 0.013). No differences were observed for Pringle maneuver duration (35 min vs. 25 min; p = ns) nor postoperative transaminases levels (p = ns). There was a trend toward a lower major complication rate in the UGH group (13 vs. 25%) and a shorter median hospital stay (8 days vs. 10 days); however, both being short of statistical significance (p = ns). Bile leak was observed in zero cases of UGH compared to 9 out of 32 cases (28%) for the control group (p = 0.020).
    Conclusions: UGH appears to be at least comparable to the standard technique in terms of intraoperative and postoperative outcomes. Accordingly, transection of the right hepatic artery and right portal vein prior to the transection phase can be omitted, at least in selected cases. These results need to be confirmed in a prospective and randomized trial.
    MeSH term(s) Humans ; Hepatectomy/methods ; Liver Neoplasms/surgery ; Prospective Studies ; Hepatic Veins/surgery ; Laparoscopy/methods
    Language English
    Publishing date 2023-04-07
    Publishing country Germany
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-023-09996-7
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  2. Article ; Online: Perioperative outcome and long-term survival for intrahepatic cholangiocarcinoma after portal vein embolization and subsequent resection: A propensity-matched study.

    Nevermann, N / Bode, J / Vischer, M / Krenzien, F / Lurje, G / Pelzer, U / Fehrenbach, U / Auer, T A / Schmelzle, M / Pratschke, J / Schöning, W

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2023  Volume 49, Issue 12, Page(s) 107100

    Abstract: ... 479) and 6 months (p = 0.013), respectively. In case of positive N-status or multifocal tumor (MF+) OS ...

    Abstract Introduction: In view of the high therapeutic value of surgical resection for intrahepatic cholangiocarcinomas (ICC), our study addresses the question of clinical management and outcome in case of borderline resectability requiring hypertrophy induction of the future liver remnant prior to resection.
    Methods: Clinical data was collected of all primary ICC cases receiving major liver resection with or without prior portal vein embolization (PVE) from a single high-volume center. PVE was performed via a percutaneous transhepatic access. Propensity score matching was performed. Perioperative morbidity was assessed as well as long-term survival with a minimum follow-up of 36 months.
    Results: No significant difference in perioperative morbidity was seen between the PVE and the control group. For the PVE group, median OS was 28 months vs. 37 months for the control group (p = 0.418), median DFS 18 and 14 months (p = 0.703). Disease progression during hypertrophy was observed in 38% of cases. Here, OS and DFS was reduced to 18 months (p = 0.479) and 6 months (p = 0.013), respectively. In case of positive N-status or multifocal tumor (MF+) OS was also reduced (18 vs. 26 months, p = 0.033; MF+: 9 vs. 36months p = 0.013).
    Conclusion: Our results suggest that the surgical therapy in case of borderline resectability offers acceptable results with non-inferior OS rates compared to cases without preoperative hypertrophy induction and comparable oncological features. In the presence of additional risk factors (multifocal tumor, lymph node metastasis, PD during hypertrophy) the OS is notably reduced.
    MeSH term(s) Humans ; Liver Neoplasms/surgery ; Liver Neoplasms/secondary ; Portal Vein/surgery ; Cholangiocarcinoma/surgery ; Embolization, Therapeutic/methods ; Hepatectomy/methods ; Bile Ducts, Intrahepatic/surgery ; Bile Duct Neoplasms/surgery ; Hypertrophy/etiology ; Hypertrophy/surgery ; Treatment Outcome
    Language English
    Publishing date 2023-10-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2023.107100
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  3. Article: The multiple functions of miR-574-5p in the neuroblastoma tumor microenvironment.

    Proestler, Eva / Donzelli, Julia / Nevermann, Sheila / Breitwieser, Kai / Koch, Leon F / Best, Tatjana / Fauth, Maria / Wickström, Malin / Harter, Patrick N / Kogner, Per / Lavieu, Grégory / Larsson, Karin / Saul, Meike J

    Frontiers in pharmacology

    2023  Volume 14, Page(s) 1183720

    Abstract: Neuroblastoma is the most common extracranial solid tumor in childhood and arises from neural crest cells of the developing sympathetic nervous system. Prostaglandin ... ...

    Abstract Neuroblastoma is the most common extracranial solid tumor in childhood and arises from neural crest cells of the developing sympathetic nervous system. Prostaglandin E
    Language English
    Publishing date 2023-09-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2587355-6
    ISSN 1663-9812
    ISSN 1663-9812
    DOI 10.3389/fphar.2023.1183720
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  4. Article ; Conference proceedings: Die Rolle der Lymphadenektomie bei malignen Lebertumoren: Erkenntnisse aus dem StuDoQ|Leberregister

    Knitter, S. / Raschzok, N. / Hillebrandt, K.-H. / Benzing, C. / Moosburner, S. / Nevermann, N. / Haber, P. K. / Gül-Klein, S. / Lurje, G. / Schöning, W. / Pratschke, J. / Krenzien, F.

    Zeitschrift für Gastroenterologie

    2023  Volume 61, Issue 08

    Event/congress Viszeralmedizin 2023 77. Jahrestagung der DGVS mit Sektion Endoskopie Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie mit den Arbeitsgemeinschaften der DGAV und Jahrestagung der CACP, Erst online. Dann Hamburg., 2023-09-11
    Language German
    Publishing date 2023-08-01
    Publisher Georg Thieme Verlag
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 201387-3
    ISSN 1439-7803 ; 0044-2771 ; 0172-8504
    ISSN (online) 1439-7803
    ISSN 0044-2771 ; 0172-8504
    DOI 10.1055/s-0043-1772088
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  5. Article ; Online: Is Repeat Resection for Recurrent Intrahepatic Cholangiocarcinoma Warranted? Outcomes of an International Analysis.

    Holzner, Matthew L / Mazzaferro, Vincenzo / Busset, Michele Droz Dit / Aldrighetti, Luca / Ratti, Francesca / Hasegawa, Kiyoshi / Arita, Junichi / Sapisochin, Gonzalo / Abreu, Phillipe / Schoning, Wenzel / Schmelzle, Mortiz / Nevermann, Nora / Pratschke, Johann / Florman, Sander / Halazun, Karim / Schwartz, Myron E / Tabrizian, Parissa

    Annals of surgical oncology

    2024  

    Abstract: Background: Recurrence of intrahepatic cholangiocarcinoma (ICC) after liver resection (LR) remains high, and optimal therapy for recurrent ICC is challenging. Herein, we assess the outcomes of patients undergoing repeat resection for recurrent ICC in a ... ...

    Abstract Background: Recurrence of intrahepatic cholangiocarcinoma (ICC) after liver resection (LR) remains high, and optimal therapy for recurrent ICC is challenging. Herein, we assess the outcomes of patients undergoing repeat resection for recurrent ICC in a large, international multicenter cohort.
    Patients and methods: Outcomes of adults from six large hepatobiliary centers in North America, Europe, and Asia with recurrent ICC following primary LR between 2001 and 2015 were analyzed. Cox models determined predictors of post-recurrence survival.
    Results: Of patients undergoing LR for ICC, 499 developed recurrence. The median time to recurrence was 10 months, and 47% were intrahepatic. Overall 3-year post-recurrence survival rate was 28.6%. In total, 121 patients (25%) underwent repeat resection, including 74 (61%) repeat LRs. Surgically treated patients were more likely to have solitary intrahepatic recurrences and significantly prolonged survival compared with those receiving locoregional or systemic therapy alone with a 3-year post-recurrence survival rate of 47%. Independent predictors of post-recurrence death included time to recurrence < 1 year [HR 1.66 (1.32-2.10), p < 0.001], site of recurrence [HR 1.74 (1.28-2.38), p < 0.001], macrovascular invasion [HR 1.43 (1.05-1.95), p = 0.024], and size of recurrence > 3 cm [HR 1.68 (1.24-2.29), p = 0.001]. Repeat resection was independently associated with decreased post-recurrence death [HR 0.58 0.43-0.78), p < 0.001].
    Conclusions: Repeat resection for recurrent ICC in select patients can result in extended survival. Thus, challenging the paradigm of offering these patients locoregional or chemo/palliative therapy alone as the mainstay of treatment.
    Language English
    Publishing date 2024-02-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1200469-8
    ISSN 1534-4681 ; 1068-9265
    ISSN (online) 1534-4681
    ISSN 1068-9265
    DOI 10.1245/s10434-024-14975-w
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    Zs.A 4042: Show issues Location:
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  6. Article ; Online: Robotic versus laparoscopic versus open major hepatectomy - an analysis of costs and postoperative outcomes in a single-center setting.

    Knitter, Sebastian / Feldbrügge, Linda / Nevermann, Nora / Globke, Brigitta / Galindo, Santiago Andres Ortiz / Winklmann, Thomas / Krenzien, Felix / Haber, Philipp K / Malinka, Thomas / Lurje, Georg / Schöning, Wenzel / Pratschke, Johann / Schmelzle, Moritz

    Langenbeck's archives of surgery

    2023  Volume 408, Issue 1, Page(s) 214

    Abstract: Purpose: In the era of minimal-invasive surgery, the introduction of robotic liver surgery (RS) was accompanied by concerns about the increased financial expenses of the robotic technique in comparison to the established laparoscopic (LS) and ... ...

    Abstract Purpose: In the era of minimal-invasive surgery, the introduction of robotic liver surgery (RS) was accompanied by concerns about the increased financial expenses of the robotic technique in comparison to the established laparoscopic (LS) and conventional open surgery (OS). Therefore, we aimed to evaluate the cost-effectiveness of RS, LS and OS for major hepatectomies in this study.
    Methods: We analyzed financial and clinical data on patients who underwent major liver resection for benign and malign lesions from 2017 to 2019 at our department. Patients were grouped according to the technical approach in RS, LS, and OS. For better comparability, only cases stratified to the Diagnosis Related Groups (DRG) H01A and H01B were included in this study. Financial expenses were compared between RS, LS, and OS. A binary logistic regression model was used to identify parameters associated with increased costs.
    Results: RS, LS and OS accounted for median daily costs of 1,725 €, 1,633 € and 1,205 €, respectively (p < 0.0001). Median daily (p = 0.420) and total costs (16,648 € vs. 14,578 €, p = 0.076) were comparable between RS and LS. Increased financial expenses for RS were mainly caused by intraoperative costs (7,592 €, p < 0.0001). Length of procedure (hazard ratio [HR] = 5.4, 95% confidence interval [CI] = 1.7-16.9, p = 0.004), length of stay (HR [95% CI] = 8.8 [1.9-41.6], p = 0.006) and development of major complications (HR [95% CI] = 2.9 [1.7-5.1], p < 0.0001) were independently associated with higher costs.
    Conclusions: From an economic perspective, RS may be considered a valid alternative to LS for major liver resections.
    MeSH term(s) Humans ; Hepatectomy/methods ; Robotic Surgical Procedures/methods ; Robotics ; Liver ; Laparoscopy/methods
    Language English
    Publishing date 2023-05-29
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-023-02953-x
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  7. Article ; Online: A surgical strategy for intrahepatic cholangiocarcinoma - the hilar first concept.

    Nevermann, Nora / Bode, Julia / Vischer, Maxine / Feldbrügge, Lina / Knitter, Sebastian / Krenzien, Felix / Pelzer, Uwe / Fehrenbach, Uli / Auer, Timo Alexander / Lurje, Georg / Schmelzle, Moritz / Pratschke, Johann / Schöning, Wenzel

    Langenbeck's archives of surgery

    2023  Volume 408, Issue 1, Page(s) 296

    Abstract: ... cases were included in the analysis. Thirty- and 90-day-mortality was 5.2% (n = 10) and 10.9% (n = 21 ...

    Abstract Purpose: The present study assesses long-term overall survival (OS) and disease-free survival (DFS) after curative resection for intrahepatic cholangiocarcinoma (ICCA) depending on resection margin (RM) status and lymph node (LN) status.
    Methods: Clinical data of all consecutively resected patients with ICCA at a single high-volume center between 2005 and 2018 were collected. Minimum follow-up was 36 months. Perioperative and long-term oncological outcome was assessed.
    Results: One hundred ninety-two cases were included in the analysis. Thirty- and 90-day-mortality was 5.2% (n = 10) and 10.9% (n = 21). OS was 26 months with 1-, 2-, and 5-year-OS rates of 72%, 53%, and 26%. One-, 2-, and 5-year-DFS rates were 54%, 42%, and 35% (N0 vs. N1: 29 vs. 9 months, p = 0.116). R1 was not found to be an independent risk factor for reduced survival in the overall cohort (p = 0.098). When differentiating according to the LN status, clear resection margins were significantly associated with increased DFS for N0 cases (50 months vs. 9 months, p = 0.004). For N1 cases, no significant difference in DFS was calculated for R0 compared to R1 cases (9 months vs. 9 months, p = 0.88). For N0 cases, clear resection margins > 10 mm were associated with prolonged OS (p = 0.048).
    Conclusion: For N1 cases, there was no significant survival benefit when comparing R0 versus R1, while the complication rate remained high for the extended resection types. In view of merging multimodal treatment, the hilar first concept assesses locoregional LN status for optimal surgical therapy.
    MeSH term(s) Humans ; Margins of Excision ; Hepatectomy ; Retrospective Studies ; Cholangiocarcinoma/pathology ; Bile Ducts, Intrahepatic/surgery ; Bile Duct Neoplasms/pathology ; Treatment Outcome ; Survival Rate
    Language English
    Publishing date 2023-08-07
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-023-03023-y
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  8. Article ; Online: Gd-EOB-DTPA-MRCP to localize bile leakage after liver trauma and surgery: impact on treatment and outcome.

    Marth, Adrian A / Auer, Timo A / Walter-Rittel, Thula C / Nevermann, Nora / Krenzien, Felix / Schmelzle, Moritz / Müller, Tobias / Kolck, Johannes / Wieners, Gero / Geisel, Dominik / Gebauer, Bernhard / Hamm, Bernd / Schöning, Wenzel / Fehrenbach, Uli

    European radiology

    2023  Volume 33, Issue 9, Page(s) 5933–5942

    Abstract: Objectives: Bile leakage (BL) is a challenging complication after hepatobiliary surgery and liver trauma. Gadolinium ethoxybenzyl (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiopancreatography (MRCP) is used to diagnose BL non-invasively. We ... ...

    Abstract Objectives: Bile leakage (BL) is a challenging complication after hepatobiliary surgery and liver trauma. Gadolinium ethoxybenzyl (Gd-EOB-DTPA)-enhanced magnetic resonance cholangiopancreatography (MRCP) is used to diagnose BL non-invasively. We assessed the value of Gd-EOB-DTPA-MRCP in the detection of postoperative and post-traumatic BL hypothesizing that exact identification of the leakage site is pivotal for treatment planning and outcome.
    Methods: We retrospectively enrolled 39 trauma and postoperative patients who underwent Gd-EOB-DTPA-MRCP for suspected BL. Three readers rated the presence of BL and leakage site (intraparenchymal, central, peripheral ± aberrant or disconnected ducts). Imaging findings were compared to subsequent interventional procedures and their complexity and outcome.
    Results: BL was detected in Gd-EOB-DTPA-MRCP in 25 of patients and was subsequently confirmed. Sites of BL differed significantly between postoperative (central [58%] and peripheral [42%]) and trauma patients (intraparenchymal [100%]; p < 0.001). Aberrant or disconnected ducts were diagnosed in 8%/26% of cases in the postoperative subgroup. Inter-rater agreement for the detection and localization of BL was almost perfect (Κ = 0.85 and 0.88; p < 0.001). Intraparenchymal BL required significantly less complex interventional procedures (p = 0.002), whereas hospitalization and mortality did not differ between the subgroups (p > 0.05).
    Conclusions: Gd-EOB-DTPA-MRCP reliably detects and exactly locates BL in postoperative and trauma patients. Exact localization of biliary injuries enables specific treatment planning, as intraparenchymal leakages, which occur more frequently after trauma, require less complex interventions than central or peripheral leaks in the postoperative setting. As a result of specific treatment based on exact BL localization, there was no difference in the duration of hospitalization or mortality.
    Clinical relevance statement: Gd-EOB-DTPA-MRCP is a reliable diagnostic tool for exactly localizing iatrogenic and post-traumatic biliary leakage. Its precise localization helps tailor local therapies for different injury patterns, resulting in comparable clinical outcomes despite varying treatments.
    Key points: • Gd-EOB-DTPA-MRCP enables adequate detection and localization of bile leakages in both postoperative and post-traumatic patients. • The site of bile leakage significantly impacts the complexity of required additional interventions. • Intraparenchymal bile leakage is commonly seen in patients with a history of liver trauma and requires less complex interventions than postoperative central or peripheral bile leakages, while hospitalization and mortality are similar.
    MeSH term(s) Humans ; Cholangiopancreatography, Magnetic Resonance/methods ; Contrast Media ; Retrospective Studies ; Bile ; Gadolinium DTPA ; Biliary Tract Diseases ; Liver/diagnostic imaging ; Liver/surgery ; Liver/pathology ; Treatment Outcome ; Magnetic Resonance Imaging/methods ; Liver Neoplasms
    Chemical Substances gadolinium ethoxybenzyl DTPA ; Contrast Media ; Gadolinium DTPA (K2I13DR72L)
    Language English
    Publishing date 2023-04-13
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1085366-2
    ISSN 1432-1084 ; 0938-7994 ; 1613-3749
    ISSN (online) 1432-1084
    ISSN 0938-7994 ; 1613-3749
    DOI 10.1007/s00330-023-09608-x
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  9. Article ; Online: Short-term postoperative outcomes of lymphadenectomy for cholangiocarcinoma, hepatocellular carcinoma and colorectal liver metastases in the modern era of liver surgery: Insights from the StuDoQ|Liver registry.

    Knitter, Sebastian / Raschzok, Nathanael / Hillebrandt, Karl-Herbert / Benzing, Christian / Moosburner, Simon / Nevermann, Nora / Haber, Philipp / Gül-Klein, Safak / Fehrenbach, Uli / Lurje, Georg / Schöning, Wenzel / Fangmann, Josef / Glanemann, Matthias / Kalff, Jörg C / Mehrabi, Arianeb / Michalski, Christoph / Reißfelder, Christoph / Schmeding, Maximilian / Schnitzbauer, Andreas A /
    Stavrou, Gregor A / Werner, Jens / Pratschke, Johann / Krenzien, Felix

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2024  Volume 50, Issue 4, Page(s) 108010

    Abstract: ... Clinicopathological data from patients who underwent surgery at 13 German centers from 2017 to 2022 (n = 3456) was ... CCA), followed by colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC). N+ status was ...

    Abstract Introduction: The clinical role of lymphadenectomy (LAD) as part of hepatic resection for malignancies of the liver remains unclear. In this study, we aimed to report on the use cases and postoperative outcomes of liver resection and simultaneous LAD for hepatic malignancies (HM).
    Materials and methods: Clinicopathological data from patients who underwent surgery at 13 German centers from 2017 to 2022 (n = 3456) was extracted from the StuDoQ|Liver registry of the German Society of General and Visceral Surgery. Propensity-score matching (PSM) was performed to account for the extent of liver resection and patient demographics.
    Results: LAD was performed in 545 (16%) cases. The most common indication for LAD was cholangiocarcinoma (CCA), followed by colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC). N+ status was found in 7 (8%), 59 (35%), and 56 cases (35%) for HCC, CCA, and CRLM, respectively (p < 0.001). The LAD rate was highest for robotic-assisted resections (28%) followed by open (26%) and laparoscopic resections (13%), whereas the number of resected lymph nodes was equivalent between the techniques (p = 0.303). LAD was associated with an increased risk of liver-specific postoperative complications, especially for patients with HCC.
    Conclusion: In this multicenter registry study, LAD was found to be associated with an increased risk of liver-specific complications. The highest rate of LAD was observed among robotic liver resections.
    MeSH term(s) Humans ; Carcinoma, Hepatocellular/surgery ; Carcinoma, Hepatocellular/pathology ; Liver Neoplasms/secondary ; Colorectal Neoplasms/pathology ; Retrospective Studies ; Hepatectomy/methods ; Cholangiocarcinoma/surgery ; Laparoscopy/methods ; Lymph Node Excision ; Bile Ducts, Intrahepatic/pathology ; Bile Duct Neoplasms/surgery ; Registries ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Propensity Score
    Language English
    Publishing date 2024-02-08
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2024.108010
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  10. Article ; Online: Minimal Invasive Versus Open Surgery for Colorectal Liver Metastases: A Multicenter German StuDoQ|Liver Registry-Based Cohort Analysis in Germany.

    Moosburner, Simon / Kettler, Chiara / Hillebrandt, Karl H / Blank, Moritz / Freitag, Hannes / Knitter, Sebastian / Krenzien, Felix / Nevermann, Nora / Sauer, Igor M / Modest, Dominik P / Lurje, Georg / Öllinger, Robert / Schöning, Wenzel / Werner, Jens / Schmeding, Maximilian / Pratschke, Johann / Raschzok, Nathanael

    Annals of surgery open : perspectives of surgical history, education, and clinical approaches

    2023  Volume 4, Issue 4, Page(s) e350

    Abstract: Objective: To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level.: Background: Colorectal cancer is the third most common malignancy ... ...

    Abstract Objective: To compare the outcome of minimally invasive liver surgery (MILS) to open liver surgery (OLS) for resection of colorectal liver metastases (CRLM) on a nationwide level.
    Background: Colorectal cancer is the third most common malignancy worldwide. Up to 50% of all patients with colorectal cancer develop CRLM. MILS represents an attractive alternative to OLS for treatment of CRLM.
    Methods: Retrospective cohort study using the prospectively recorded German Quality management registry for liver surgery. Propensity-score matching was performed to account for variance in the extent of resection and patient demographics.
    Results: In total, 1037 patients underwent liver resection for CRLM from 2019 to 2021. MILS was performed in 31%. Operative time was significantly longer in MILS (234
    Conclusion: MILS is not the standard for resection of CRLM in Germany. Drawbacks, such as a longer operative time remain. However, if technically possible, MILS is a reasonable alternative to OLS for resection of CRLM, with comparable postoperative complications, reduced LOS, and equal oncological radicality.
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ISSN 2691-3593
    ISSN (online) 2691-3593
    DOI 10.1097/AS9.0000000000000350
    Database MEDical Literature Analysis and Retrieval System OnLINE

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