Comparison between laparoscopic and open parenchyma-sparing liver resections

Aim. To compare the early and long-term outcomes of open and laparoscopic parenchyma-sparing liver resections for colorectal cancer metastases. Materials and methods. A retrospective analysis of the outcomes of parenchymal liver resections performed from 2015 to 2024 in 54 patients with colorectal cancer metastases is carried out using the inverse probability of treatment weighting (IPTW). Variables included the tumor burden score, chemotherapy-related liver injury, location in liver segments 7 or 8, a simultaneous operation, bilobar involvement, and the number of metastases. Results. Standard statistical analysis revealed no significant differences in the early postoperative outcomes between the compared groups. The duration of laparoscopic surgeries and hospital stay after these operations were shorter but differed insignificantly. Binary logistic regression analysis using the IPTW demonstrated that laparoscopic access (OR 0.754; p = 0.039) and location in liver segments 7 or 8 (OR 1.294; p = 0.027) statistically significantly influenced the likelihood of complications. Survival analysis using the IPTW showed no statistically significant differences in overall survival and recurrence-free survival. Conclusion. Laparoscopic parenchyma-sparing liver resection provides an effective alternative to open resection, having no influence on long-term outcomes and the potential to improve immediate ones.