BACKGROUND Laparoscopic redo resections for colorectal metastases are poorly investigated. This study aims to explore long-term results after second, third, and fourth resections. MATERIAL AND METHODS Prospectively updated databases of primary and redo laparoscopic liver resections in six European HPB centers were analyzed. Procedure-related overall survival after first, second, third, and fourth resections were evaluated. Furthermore, patients without liver recurrence after first liver resection were compared to those with one redo, two or three redo, and patients with palliative treatment for liver recurrence after first laparoscopic liver surgery. Survival was calculated both from the date of the first liver resection and from the date of the actual liver resection. In total, 837 laparoscopic primary and redo liver resections performed in 762 patients were included (630 primary, 172 first redo, 29 second redo, and 6 third redo). Patients were bunched into four groups: Group 1-without hepatic recurrence after primary liver resection (n = 441); Group 2-with liver recurrence who underwent only one laparoscopic redo resection (n = 154); Group 3-with liver recurrence who underwent two laparoscopic redo resections (n = 29); Group 4-with liver recurrence who have not been found suitable for redo resections (n = 138). RESULTS No significant difference has been found between the groups in terms of baseline characteristics and surgical outcomes. Rate of positive resection margin was higher in the group with palliative recurrence (group 4). Five-year survival calculated from the first liver resection was 67%, 62%, 84%, and 7% for group 1, 2, 3, and 4, respectively. Procedure-specific 5-year overall survival was 50% after primary laparoscopic liver resection, 52% after the 1st reoperation, 52% after the 2nd, and 40% after the 3rd reoperation made laparoscopic. CONCLUSIONS Multiple redo recurrences can be performed laparoscopically with good long-term results. Liver recurrence does not aggravate prognosis as long as the patient is suitable for reoperation.

中文翻译：

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转移性结直肠癌患者腹腔镜保留实质肝切除术后的长期肿瘤学结果：一项欧洲多中心研究。

背景技术对结直肠转移瘤的腹腔镜重做切除术的研究很少。本研究旨在探索第二次、第三次和第四次切除后的长期结果。材料和方法 对六个欧洲 HPB 中心前瞻性更新的初次和重做腹腔镜肝切除术数据库进行了分析。评估了第一次、第二次、第三次和第四次切除后与手术相关的总生存期。此外，将第一次肝切除术后没有肝复发的患者与第一次肝切除术后肝复发的患者进行比较，两次或三次重做，以及第一次腹腔镜肝脏手术后肝复发的姑息治疗患者。从第一次肝切除的日期和实际肝切除的日期计算存活率。总共，包括在 762 名患者中进行的 837 次腹腔镜原发性和重做肝切除术（630 名原发性肝切除术，172 名第一次重做，29 名第二次重做和 6 名第三次重做）。患者分为四组： 第一组——原发性肝切除术后没有肝复发（n = 441）；第 2 组——肝脏复发，仅接受了一次腹腔镜重做切除术（n = 154）；第 3 组——肝复发，接受了两次腹腔镜重做切除术（n = 29）；第 4 组 - 未发现适合重新切除的肝脏复发（n = 138）。结果 在基线特征和手术结果方面，两组之间没有发现显着差异。姑息性复发组（第 4 组）的切缘阳性率较高。从第一次肝切除算起的五年生存率为 67%、62%、84%、第 1 组、第 2 组、第 3 组和第 4 组分别为 7% 和 7%。初次腹腔镜肝切除术后特定手术的 5 年总生存率为 50%，第 1 次再手术后为 52%，第 2 次为 52%，第 3 次腹腔镜再手术后为 40%。结论 多次重做复发可以通过腹腔镜进行，具有良好的长期效果。只要患者适合再次手术，肝脏复发不会加重预后。