Comparison of parenchyma-sparing and anatomical resections for colorectal liver metastases: a meta-analysis

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

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. 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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