Abstract
OBJECTIVE: This study aimed to compare the short-term outcomes of Indocyanine Green (ICG) assisted minimally invasive surgery (MIS) with Intraoperative Ultrasound (IOUS) against conventional MIS with IOUS alone and open surgery with tactility and IOUS for colorectal liver metastases (CRLM). And identify risk factor of R1 resection (tumor-negative margin < 1 mm) by statistical analysis. MATERIALS AND METHODS: A retrospective cohort analysis was conducted on 86 patients with 158 CRLM tumors undergoing hepatectomy. Patients were categorized into three groups: Group A (ICG + IOUS MIS, n = 14, tumor = 23), Group B (IOUS only MIS, n = 16, tumor = 20), and Group C (tactile + IOUS Open surgery, n = 56, tumor = 115). Statistical analysis involved univariate analysis and multivariable logistic regression were performed. RESULTS: Group A demonstrated superior R0 resection (tumor-negative margin ≥ 1 mm) rates, shorter median hospital stays compared to Groups C. Intraoperatively, Group A exhibited reduced blood loss and shorter operative times (213.5 vs. 351.5 min, p = 0.02) compared to Group C. Multivariable analysis identified surgical approach, lower Ki-67 expression, higher body weight and more metastatic lesions as independent predictors of R1 resection. CONCLUSION: ICG assisted MIS significantly reduces R1 resection rates, postoperative hospitalization time and costs compared to conventional MIS or open surgery.