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International Journal of Surgical Oncology
Volume 2011 (2011), Article ID 686030, 12 pages
http://dx.doi.org/10.1155/2011/686030
Review Article

Minimally Invasive Evaluation and Treatment of Colorectal Liver Metastases

1Department of Surgery, Saint Agnes Hospital, 900 Caton Avenue, Mailbox no. 207, Baltimore, MD 21229, USA
2Department of Surgery, Saint Joseph Hospital, Baltimore, MD 21231, USA

Received 7 January 2011; Accepted 5 May 2011

Academic Editor: Abdullah Al Haddad

Copyright © 2011 Anton L. Gueorguiev et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Minimally invasive techniques used in the evaluation and treatment of colorectal liver metastases (CRLMs) include ultrasonography (US), computed tomography, magnetic resonance imaging, percutaneous and operative ablation therapy, standard laparoscopic techniques, robotic techniques, and experimental techniques of natural orifice endoscopic surgery. Laparoscopic techniques range from simple staging laparoscopy with or without laparoscopic intraoperative US, through intermediate techniques including simple liver resections (LRs), to advanced techniques such as major hepatectomies. Hereins, we review minimally invasive evaluation and treatment of CRLM, focusing on a comparison of open LR (OLR) and minimally invasive LR (MILR). Although there are no randomized trials comparing OLR and MILR, nonrandomized data suggest that MILR compares favorably with OLR regarding morbidity, mortality, LOS, and cost, although significant selection bias exists. The future of MILR will likely include expanding criteria for resectability of CRLM and should include both a patient registry and a formalized process for surgeon training and credentialing.