The Laparoscopic Approach in the Surgical Management of Liver Metastases in Patients with Colorectal Cancer: A Narrative Review and Practical Recommendations
Bezverkhnyi V.А.1, Burlaka A.A.2,3
- 1Irpin Military Hospital, Irpin, Ukraine
- 2Nonprofit Organization National Cancer Institute, Kyiv, Ukraine
- 3Bogomolets National Medical University, Kyiv, Ukraine
Summary. The aim of this review is to evaluate current evidence regarding the efficacy and safety of laparoscopic liver resection for the management of colorectal cancer liver metastases (CRLM). A structured literature search was conducted in PubMed for the period 2015–2025, including randomized controlled trials, prospective studies, high-quality retrospective analyses, and meta-analyses. The evidence indicates that the laparoscopic approach is associated with reduced surgical trauma, a 30–50% decrease in postoperative morbidity, shorter hospital stay by 2–3 days, and an attenuated systemic inflammatory response (approximately 40% reduction in IL-6 levels), while maintaining oncological radicality and comparable 5-year overall survival rates (44–45%). Special attention is given to the learning curve, technical challenges of resections in posterosuperior segments, the role of laparoscopy in repeat hepatectomy, two-stage strategies, and mini-ALPPS (Associating Liver Partitioning and Portal vein ligation for Rapid Segmentation). Globally, the proportion of laparoscopic liver resections in leading centers reaches 35–40%, reflecting its broad implementation in clinical practice. These findings support the feasibility and rationale for widespread adoption of laparoscopic liver resection in CRLM management, provided that the surgical team has adequate expertise and technical resources.
Leave a comment