Background: The purpose of this original article was to evaluate the impact of the Pringle maneuver on the survival of patients with colorectal liver metastases. Methods: Eighty patients with colorectal liver metastases were randomized to undergo hepatectomy with (39 patients, HPC group) or without (41 patients, NHPC group) pedicle clamping. Results: The two groups were homogeneous. Mortality and morbidity rates were similar. Blood transfusions rates were higher in HPC group (p = 0.010). Median follow-up was 67.1 ± 20 months in the HPC group and 77.5 ± 16.6 months in the other group (p = 0.07). Overall survival at 1, 3, and 5 years was 100%, 86.1%, and 49.4% in HPC group vs. 92.6%, 65.8%, and 48.2% in NHPC group (p = 0.704). Disease-free survival was similar between the two groups: 1-, 3- and 5-year survival rates were 85.7%, 51.4%, and 34.3% in the HPC group vs. 84%, 51.5%, and 37.9% in NHPC group (p = 0.943). The incidence of hepatic recurrence was similar in the two groups (p = 0.506). Median time to hepatic recurrence was similar in the two groups (p = 0.482). Overall and disease-free survival rates were similar even when the Pringle maneuver was longer than 45 min (p = 0.571 and 0.948) and in patients with liver steatosis (p = 0.779 and 0.412). Conclusions: The Pringle maneuver does not seem to affect the survival of patients with liver metastases.
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