hepatoАнналы хирургической гепатологииAnnaly khirurgicheskoy gepatologii = Annals of HPB Surgery1995-54642408-9524НЭИКОН ИСП10.16931/1995-5464.2022-4-57-70hepato-952Research ArticleСОВРЕМЕННЫЕ ТЕНДЕНЦИИ В ХИРУРГИИ ПЕЧЕНИCURRENT TRENDS IN LIVER SURGERYСравнение лапароскопических и открытых симультанных операций при синхронных метастазах колоректального рака в печени: метаанализComparison of laparoscopic and open simultaneous surgeries for synchronous metastases of colorectal cancer in the liver: meta-analysishttps://orcid.org/0000-0002-8220-4191ИвановаО. А.IvanovaO. A.

Иванова Ольга Александровна – аспирант отделения абдоминальной онкологии 

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86

Olga A. Ivanova – Postgraduate of the Department of Abdominal Oncology 

86, Profsoyuznaya str., GPS-7, Moscow, 117997

Phone: +7-922-866-31-19 

Olga.Ivanova92.17@yandex.ruhttps://orcid.org/0000-0002-5011-4853АхаладзеГ. Г.AkhaladzeG. G.

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

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86

Guram G. Akhaladze – Doct. of Sci. (Med.), Professor, Principal Researcher, Research Department of Surgery and Surgical Technologies in Oncology

86, Profsoyuznaya str., GPS-7, Moscow, 117997

gur371ax@gmail.comhttps://orcid.org/0000-0001-7914-1882ГончаровС. В.GoncharovS. V.

Гончаров Сергей Владимирович – канд. мед. наук, заведующий отделением абдоминальной онкологии

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86

Sergei V. Goncharov – Cand. of Sci. (Med.), Head of the Department of Abdominal Oncology

86, Profsoyuznaya str., GPS-7, Moscow, 117997

9015@mail.ruhttps://orcid.org/0000-0002-1396-1789ГребенкинЕ. Н.GrebenkinE. N.

Гребенкин Егор Николаевич – канд. мед. наук, заместитель главного врача по инновационному развитию

305524, Курский р-н, Рышковский с/с, х. Кислино, ул. Елисеева, д. 1

Egor N. Grebenkin – Cand. of Sci. (Med.), Deputy Chief Physician for Innovative Development

1, Eliseeva str., Kislino Khutor, Ryshkovsky Selsoviet Rural Settlement Kursk Region

genbytu@mail.ruhttps://orcid.org/0000-0002-9057-6227СтаноевичУ. С.StanojevicU. S.

Станоевич Углеша Спасоевич – доктор мед. наук, главный врач 

305524, Курский р-н, Рышковский с/с, х. Кислино, ул. Елисеева, д. 1

Uglesha S. Stanojevic – Doct. of Sci. (Med.), Chief Physician

1, Eliseeva str., Kislino Khutor, Ryshkovsky Selsoviet Rural Settlement Kursk Region

ugljesha@mail.ruhttps://orcid.org/0000-0002-1641-6452СолодкийВ. А.SolodkiyV. A.

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

117997, ГПС-7, Москва, ул. Профсоюзная, д. 86

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

86, Profsoyuznaya str., GPS-7, Moscow, 117997

mailbox@rncrr.ruФГБУ “Российский научный центр рентгенорадиологии” Минздрава РоссииРоссияRussian Scientific Center of Roentgenoradiology of the Ministry of Healthcare of the Russian FederationRussian FederationОБУЗ “Курский областной клинический онкологический диспансер” Комитета здравоохранения Курской областиRussian FederationKursk Regional Clinical Oncology DispensaryRussian Federation2022151220222745770Copyright © Иванова О.А., Ахаладзе Г.Г., Гончаров С.В., Гребенкин Е.Н., Станоевич У.С., Солодкий В.А., 20222022Иванова О.А., Ахаладзе Г.Г., Гончаров С.В., Гребенкин Е.Н., Станоевич У.С., Солодкий В.А.Ivanova O.A., Akhaladze G.G., Goncharov S.V., Grebenkin E.N., Stanojevic U.S., 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/952

Цель. Анализ исследований, посвященных сравнению лапароскопических и открытых симультанных операций при синхронных метастазах колоректального рака в печени.Материал и методы. В электронных базах данных PubMed, Web of Science, Scopus, Embase, Cochrane Library до 20 октября 2020 г. проведен поиск исследований, посвященных сравнению открытых и лапароскопических симультанных операций при синхронном метастатическом поражении печени. Ключевые слова: simultaneous resections, colorectal cancer, liver metastases, simultaneous laparoscopic.Результаты. Метаанализ содержит результаты 1211 симультанных операций при синхронных метастазах колоректального рака в печени: 450 лапароскопических и 761 – открытых. Лапароскопические операции отличались меньшей кровопотерей (взвешенная разность средних (ВРС) = –131,77, 95% ДИ [–232,54; –31,00], р = 0,01), меньшей продолжительностью пребывания в стационаре после операции (ВРС = –2,87, 95% ДИ [–3,41; –2,33], р < 0,00001), ранним первым актом дефекации (ВРС = –0,99, 95% ДИ [–1,40; –0,58], р < 0,0001), ранним началом энтерального питания (ВРС = –1,20, 95% ДИ [–2,06; –0,33], р = 0,007]), меньшей частотой послеоперационных осложнений (ОШ = 0,60, 95% ДИ [0,46–0,80], р = 0,0004). Выявлено статистически значимое преимущество лапароскопического доступа в общей (ОР = 0,80, 95% ДИ 0,64–0,99, р = 0,04) и безрецидивной (ОР = 0,73, 95% ДИ [0,60–0,89], р = 0,002) выживаемости.Заключение. Периоперационные и отдаленные онкологические результаты свидетельствуют о безопасности и эффективности лапароскопических симультанных операций при синхронных метастазах колоректального рака по сравнению с открытыми вмешательствами.

Aim. To analyze studies focused on comparing laparoscopic and open simultaneous surgeries for synchronous metastases of colorectal cancer in the liver.Materials and methods. The electronic databases PubMed, Web of Science, Scopus, Embase, Cochrane Library were searched for the studies focused on the comparison of open and laparoscopic simultaneous surgeries for synchronous metastatic liver lesions, dated till October 20, 2020. Keywords: simultaneous resections, colorectal cancer, liver metastases, simultaneous laparoscopic.Results. Meta-analysis contains the results of 1211 simultaneous surgeries for simultaneous metastases of colorectal cancer in the liver: 450 laparoscopic and 761 open surgeries. Laparoscopic surgery was characterized with lower blood loss [weighted mean difference (WMD) = -131.77, 95% CI: -232.54 to -31.00, p = 0.01], a shorter postoperative hospitalization [WMD = -2.87, 95% CI: -3.41 to -2. 33, p < 0.00001], early first bowel movement [WMD = -0.99, 95% CI: -1.40 to -0.58, p < 0.0001], early initiation of enteral feeding [WMD = -1.20, 95% CI: -2.06 to -0.33, p = 0.007]), lower incidence of postoperative complications [OR = 0.60, 95% CI: 0.46–0.80, p = 0.0004]. A statistically significant advantage of laparoscopic access was established in overall [OR = 0.80, 95% CI: 0.64–0.99, p = 0.04] and recurrence-free survival [OR = 0.73, 95% CI: 0.60–0.89, p = 0.002].Conclusion. Perioperative and distant oncologic outcomes demonstrate safety and efficacy of laparoscopic simultaneous interventions for synchronous metastases of colorectal cancer in comparison with open interventions.

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