Management of Liver Metastasis from Colo-Rectal Carcinoma with Laparoscopy: A Literature Review
AbstractBackground: Worldwide, colo-rectal carcinoma is the second most common cancer with liver metastases as its major cause of mortality.This malignant condition is now seen more frequently in our environment typically at a late stage with distant metastasis especially to the liver. This study aims at highlighting the current use of laparoscopy in the management of liver metastases from colo-rectal cancer and its outcome.
Aims: To highlight the current use of laparoscopy in diagnosis, staging and treatment of liver metastasis from colorectal cancer with an evaluation of the outcome thus encouraging its practice in our subregion.
Method: Medline, Google, Highwire and Cochrane databases were searched. The search words were “metastatic colorectal cancer(MCC)” and “laparoscopic liver resection”. Review of relevant articles with literature in English language. Cross- referenced articles were also reviewed.
Results: Laparoscopy and intraoperative ultrasonography were shown to improve accuracy of diagnosis. Large multi-centre studies showed reduced blood loss, intra-operative/ post-operative morbidity and reduced length of hospital stay in laparoscopic liver resection for metastatic colorectal cancer.No large prospective randomised clinical trial comparing laparoscopic vs open hepatic resection was found. Laparoscopic ablative therapies were found to be useful in non-resectable liver metastasis.
Conclusion: Laparoscopic liver resection was found to be a favorable alternative to open resection in metastatic colorectal cancer and is associated with low morbidity and mortality in properly selected cases in specialized centres. There is however a steep learning curve required for such good outcome.