ASCO 2019 — Expert Commentary: Laparoscopic surgery best for CRC liver metastases

  • Debra Gordon
  • Oncology Conference reports
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Below is an excerpt from an on-site interview with Åsmund Avdem Fretland, MD, a surgeon in the Intervention Centre and the Department of HPB Surgery at Oslo University Hospital, Norway, about his study demonstrating similar outcomes and significantly lower 30-day complication rate with laparoscopic vs open liver surgery for liver metastases in colorectal cancer:

  • "The liver has been one of the final boundaries for laparoscopic surgery because the liver is hidden by the ribs and is very well attached. It is also the filter for the blood, so you have to control bleeding and be very meticulous about the anatomy. You have to know if a big vessel is going into the area where you are cutting. If you don't, you will have trouble."
  • "A very important message coming from this research is that our group had large experience with laparoscopic surgery before we started this trial. A lot of surgeons are excellent surgeons, but haven’t made the switch to laparoscopic surgery. Most need quite the training program, particularly to have the same results with the liver as with open surgery. We expect that the next generation of surgeons will be more proficient."
  • "From now on, if you have training in laparoscopic liver surgery, you shouldn’t be afraid of doing it on the liver. There was concern that the oncologic results wouldn’t be as good as with open surgery, but now we know that the results and survival are the same."
  • "Another advantage is that many of these patients will likely need additional surgeries as the tumor recurs. It’s easier to do a second and third if the first was done laparoscopically. That’s because there are fewer adhesions and less injury [to] the abdominal wall."

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