Quality of life is better after laparoscopic liver resection compared to open liver resection – results from the Oslo Comet-Study

Quality of life is better after laparoscopic liver resection compared to open liver resection – results from the Oslo Comet-Study

E-HPBA: Free Prize Papers (1.57e3.85) and OR 1.99 (1.27e3.12), respectively. Within volume categories, 90-day mortality did not change over time. Cond...

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E-HPBA: Free Prize Papers (1.57e3.85) and OR 1.99 (1.27e3.12), respectively. Within volume categories, 90-day mortality did not change over time. Conditional survival adjusted for confounding factors was significantly increased in the 40+ category compared to hospital volumes <5 and 5e19 procedures per year: HR 1.54 (95%CI 1.24e1.90) and HR 1.33 (1.15e 1.55). With increasing hospital volume, median survival was 19, 18, 21 and 26 months. Overall survival was significantly worse in all individual volume categories compared to the 40+ volume category: HR 1.65 (95%CI 1.35e2.01), HR 1.39 (1.21e1.60) and HR 1.19 (1.04e 1.37), respectively. Conclusions: In a nation-wide registry, improved postoperative mortality and long-term survival were found to extend beyond previously studied volume categories. To validate these findings future studies including more extensive case-mix correction are required.

LIVER 607 QUALITY OF LIFE IS BETTER AFTER LAPAROSCOPIC LIVER RESECTION COMPARED TO OPEN LIVER RESECTION e RESULTS FROM THE OSLO COMET-STUDY A. A. Fretland, M. H. Andersen, V. J. Dagenborg, M. W. Fagerland, G. M. Bjørnelv, B. A. Bjørnbeth and B. Edwin Oslo University Hospital, Norway Aims: Despite the lack of randomized controlled trials, laparoscopic liver resections are performed in specialized centres all over the world. In this predefined sub study of

HPB 2016, 18 (S2), e810ee813

e813

the randomized «Oslo CoMet study», we examined patients’ health related quality of life (HRQoL) after open and laparoscopic liver resection for colorectal metastases. Methods: From February 2012 to March 2014, 128 patients were randomly assigned to either open liver resection (OLR, n = 68) or laparoscopic liver resection (LLR, n = 60)). All the patients had parenchyma-sparing resection of one or more colorectal liver metastases. To assess patients’ HRQoL, patients filled in the SF-36 questionnaire at baseline, at 1 month and 4 months after surgery. The Physical Component Summary (PCS) of the SF-36 is a validated measure of postoperative recovery after surgery. In total 330 forms from 122 patients were available for statistical analysis. The differences between means for OLR group and LLR group were estimated with linear mixed model analysis. The models included measurements from all time points and an adjustment for the use of adjuvant chemotherapy. Results: The groups were similar at baseline. In the laparoscopic group, the mean Physical Component Summary (PCS) changed from 47.4 [95% CI, 44.7e50.2] at baseline to 44.3 [95% CI, 41.5e47.2] at one month and 47.5 [95% CI, 45.1e49.8] at four months. In the open group the PCS changed from 48.5 [95% CI, 45.9e51.2] to 41.7 [95% CI, 38.9e44.5] at one month and 45.4 [95% CI, 43.1e47.6] at four months. The between groups difference (LLR to OLR) was 3.7 [95% CI, 7.1e0.35, p = 0.03] at one month, and 3.12 [95% CI, 6.4e0.05, p = 0.046] at four months. Conclusions: In this randomized study, patients operated with laparoscopic liver resection reported better postoperative HRQoL than patients operated with open liver resection. The difference was statistically significant at both one month and four months after surgery.