Background: The question, whether to perform either a segmental, or a major liver resection if both procedures are technically feasible, continues to be under debate.
Methods: Outcomes from 188 liver resections for colorectal cancer liver metastases in the Naval Hospital of Varna in 2000-2007 were reviewed. All surviving patients were followed-up for a minimum of 2 years. Morbidity, mortality, mean blood loss, mean blood transfusion, disease-free survival and overall survival rates of the patients undergoing segmental liver resection (group one, n=76) and major liver resection (group two, n=112) were statistically compared.
Results: No patients died in group one while 7 patients (3.7%) died in the early postoperative period in group two. There were 18 postoperative complications in group one (23%) and 38 in group two (33%) (p less than 0.05). The mean blood loss was 1,245 +/- 128 mL in group two and 423 +/- 232 mL in group one (p less than 0.001) while the mean blood transfusion requirement was 2 units (0-18 units) for patients with major liver resections and 0.5 unit (0-3 units) for those with segmentectomies (p less than 0.006). There were no statistically significant differences in disease-free survival (p=0.545) and overall survival rates (p=0.750) between both groups.
Conclusion: Segmental resection enables sufficient liver volume conservation. It results in lower perioperative morbidity and mortality rates and more seldom postoperative failure. Thus it warrants disease-free and overall survival rates similar to those following the major resection.