ABSTRACT
Objective:To analyze the role of parenchymal-sparing hepatectomy (PSH) in surgical treatment of colorectal liver metasta-ses (CRLM). Methods:All CRLM patients registered in our database who underwent liver resection were assigned into two groups:the PSH group and the major hepatectomy (MH) group. Clinical characteristics were retrospectively analyzed. Surgical outcomes, survival time, and recurrence were compared between the two groups. Results:A total of 377 patients were enrolled. Except for tumor num-bers, no significant difference was found in patient demographics and tumor characteristics between the 2 groups. The rate of PSH in-creased over the study period. Short-term surgical outcomes were better in the PSH group than in the MH group. Surgery time was sig-nificantly shorter (177.5 min vs. 220 min, P=0.000), blood loss was significantly reduced (150 mL vs. 300 mL, P=0.000), and morbidity was significantly reduced (47.4%vs. 64.8%, P=0.008). No significant difference was found in overall survival (OS) time (43 m vs. 41 m, P=0.750) between the 2 groups. Hepatic recurrence-free survival time (21 m vs. 13 m, P=0.344) was similar between the 2 groups. However, local treatment was more frequently performed in the PSH group (42.8%vs. 25.6%, P=0.040) when disease recurred. The 5-year OS was significantly better in patients undergoing local treatment than in those without undergoing local treatment (58 m vs. 24 m, P=0.000), for hepatic recurrence. Conclusion:PSH did not increase hepatic recurrence but improve salvage ability in case of recur-rence with a better short-term surgical outcome. PSH should be the recommended approach at initial hepatectomy.