hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2025-4-33-43hepato-1235Research ArticleПЕЧЕНЬLIVERСравнение паренхимосберегающих и анатомических резекций при метастазах колоректального рака в печени: метаанализComparison of parenchyma-sparing and anatomical resections for colorectal liver metastases: a meta-analysishttps://orcid.org/0000-0002-0824-5980БалиевЗ. Э.BalievZ. E.

Балиев Заур Эмирович – аспирант отделения хирургических методов лечения и противоопухолевой лекарственной терапии абдоминальной онкологии с койками абдоминальной хирургии

117997, Москва, ул. Профсоюзная, д. 86

Zaur E. Baliev – Clinical Resident, Department of Surgical Methods of Treatment and Antitumor Drug Therapy of Abdominal Oncology with Abdominal Surgery Beds

86,Profsoyusnaya str., Moscow, 117997

dr.zaur.baliev@mail.ruhttps://orcid.org/0000-0001-7914-1882ГончаровС. В.GoncharovS. V.

Гончаров Сергей Владимирович – доктор мед. наук, заведующий отделением хирургических методов лечения и противоопухолевой лекарственной терапии абдоминальной онкологии с койками абдоминальной хирургии

117997, Москва, ул. Профсоюзная, д. 86

Sergei V. Goncharov – Doct. of Sci. (Med.), Head of Department of Surgical Methods of Treatment and Antitumor Drug Therapy of Abdominal Oncology with Abdominal Surgery Beds

86,Profsoyusnaya str., Moscow, 117997

9015@mail.ruhttps://orcid.org/0000-0002-5002-3521РагимовВ. А.RagimovV. A.

Рагимов Вадим Абдурагимович – канд. мед. наук, научный сотрудник лаборатории хирургических технологий в онкологии научно-исследовательского отдела хирургии, урологии, гинекологии и инвазивных технологий в онкологии

117997, Москва, ул. Профсоюзная, д. 86

Vadim A. Ragimov – Cand. of Sci. (Med.), Laboratory of Surgical Technologies in Oncology, Research Department of Surgery, Urology, Gynecology and Invasive Technologies in Oncology

86,Profsoyusnaya str., Moscow, 117997

vadim555707@mail.ruhttps://orcid.org/0000-0002-5011-4853АхаладзеГ. Г.AkhaladzeG. G.

Ахаладзе Гурам Германович – доктор мед. наук, профессор, главный научный сотрудник лаборатории хирургических технологий в онкологии научно-исследовательского отдела хирургии, урологии, гинекологии и инвазивных технологий в онкологии

117997, Москва, ул. Профсоюзная, д. 86

Guram G. Akhaladze – Doct. of Sci. (Med.), Professor, Chief Researcher, Laboratory of Surgical Technologies in Oncology, Research Department of Surgery, Urology, Gynecology and Invasive Technologies in Oncology

86,Profsoyusnaya str., Moscow, 117997

gur371ax@gmail.comhttps://orcid.org/0000-0002-1641-6452СолодкийВ. А.SolodkiyV. A.

Солодкий Владимир Алексеевич – доктор мед. наук, профессор, академик РАН, директор

117997, Москва, ул. Профсоюзная, д. 86

Vladimir A. Solodkiy – Doct. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director of the Russian Scientific Center of Roentgenoradiology, Honored Doctor of the Russian Federation

86,Profsoyusnaya str., Moscow, 117997

mailbox@rncrr.ruФГБУ “Российский научный центр рентгенорадиологии” Минздрава РоссииРоссияRussian Scientific Center of Roentgenoradiology of the Ministry of Healthcare of the Russian FederationRussian Federation2025221220253043343Copyright © Балиев З.Э., Гончаров С.В., Рагимов В.А., Ахаладзе Г.Г., Солодкий В.А., 20252025Балиев З.Э., Гончаров С.В., Рагимов В.А., Ахаладзе Г.Г., Солодкий В.А.Baliev Z.E., Goncharov S.V., Ragimov V.A., Akhaladze G.G., Solodkiy V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://hepato.elpub.ru/jour/article/view/1235Цель

Цель. Метаанализ публикаций, посвященных сравнению паренхимосберегающих и анатомических резекций печени.

Материал и методы

Материал и методы. В базах данных PubMed, Web of Science, Scopus, Embase и Cochrane Library до 31.12.2024 провели поиск исследований, посвященных сравнению паренхимосберегающих и анатомических резекций при метастазах колоректального рака в печени.

Результаты

Результаты. Проводили сравнение результатов ретроспективных исследований (21 работа). По результатам анализа установили, что паренхимосберегающие резекции отличались меньшей длительностью (ВРС −39,11; 95% ДИ [−64,73, −13,49]; р = 0,003), кровопотерей (ВРС −278,86; 95% ДИ [−465,88, −91,83]; р = 0,003), продол- жительностью госпитализации (ВРС −1,81; 95% ДИ [−2,96, −0,67]; р = 0,002). Частота послеоперационных осложнений статистически не отличалась. Послеоперационная летальность (ОШ 0,29; 95% ДИ [0,18, 0,46]; р < 0,00001), частота послеоперационной печеночной недостаточности (ОШ 0,17; 95% ДИ [0,07, 0,38]; р = 0,00001) и частота послеоперационных гемотрансфузий (ОШ 0,40; 95% ДИ [0,22, 0,75]; р = 0,004) были больше при анатомических резекциях. Общая (ОР 1,07; 95% ДИ [0,97, 1,17]; р = 0,2) и безрецидивная (ОР 1,09; 95% ДИ [0,98, 1,21]; р = 0,11) выживаемость статистически не отличались. Частота рецидива (ОШ 1,41; 95% ДИ [0,94, 2,10]; р = 0,10) и положительный край резекции (ОШ 1,39; 95% ДИ [0,97, 1,99]; р = 0,07) достоверно не отличались.

Заключение

Заключение. Проведенный анализ демонстрирует преимущества в непосредственных результатах паренхимо-сберегающих резекций по сравнению с анатомическими при сопоставимых отдаленных результатах.

Aim

Aim. To conduct a meta-analysis of studies comparing parenchyma-sparing and anatomical liver resections.

Material and Methods

Material and Methods. A search was performed in PubMed, Web of Science, Scopus, Embase, and the Cochrane Library for studies published up to 31 December 2024 that compared parenchyma-sparing and anatomical resections for colorectal liver metastases.

Results

Results. The analysis included retrospective studies (21 publications). Parenchyma-sparing resections were associated with shorter operative duration (WMD –39.11; 95% CI [–64.73, –13.49]; p = 0.003), lower blood loss (WMD –278.86; 95% CI [–465.88, –91.83]; p = 0.003), and shorter hospital stay (WMD –1.81; 95% CI [–2.96, –0.67]; p = 0.002). The overall incidence of postoperative complications did not differ significantly. Postoperative mortality (OR 0.29; 95% CI [0.18, 0.46]; p < 0.00001), postoperative liver failure (OR 0.17; 95% CI [0.07, 0.38]; p = 0.00001), and postoperative transfusion rates (OR 0.40; 95% CI [0.22, 0.75]; p = 0.004) were higher after anatomical resections. Overall survival (HR 1.07; 95% CI [0.97, 1.17]; p = 0.2) and recurrence-free survival (HR 1.09; 95% CI [0.98, 1.21]; p = 0.11) did not differ significantly. Recurrence rates (OR 1.41; 95% CI [0.94, 2.10]; p = 0.10) and positive resection margins (OR 1.39; 95% CI [0.97, 1.99]; p = 0.07) also showed no statistically significant differences.Conclusion. The analysis demonstrates advantages in short-term outcomes for parenchyma-sparing resections compared with anatomical resections, while long-term outcomes remain comparable.

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The authors declare that there are no conflicts of interest present.