Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases : An Individual Participant Data Meta-analysis of Four Randomized Clinical Trials.

Laparoscopic liver resection for colorectal liver metastases is linked to lower postoperative morbidity than open surgery (19% vs. 27%) in 761 RCT patients.

• Why it matters: Prior RCTs have not comprehensively evaluated long-term oncologic outcomes and subgroup effects between laparoscopic and open approaches for colorectal liver metastases.
• What they did: The authors pooled individual participant data from all four published RCTs (modified intention-to-treat) using trial-adjusted regression models and g-computation, with 95% CIs from nonparametric bootstrap resampling.
• The result: After median 93 months follow-up, overall survival and disease-free survival did not differ between groups, with 90-day mortality of 1.8% after LLR and 0.8% after OLR.