Keyhole surgery for colorectal cancer in the liver means fewer complications

If colorectal cancer has spread to your liver, or a loved one’s has, here is welcome news. Surgery through a few small cuts with a camera led to fewer complications than surgery through a large incision. And people lived just as long.

That comes from a review that pooled patient data from every published randomized trial on the question. It gives you something useful to bring to the surgeon’s office.

How the study worked

Researchers gathered patient-level data, including unpublished data, from all 4 published randomized trials. That came to 761 patients: 384 had keyhole (laparoscopic) surgery and 377 had open surgery. People were followed for a median of 93 months. The results appeared Oct. 27, 2026, in Annals of Internal Medicine, and the analysis used only the information that all the trials had in common.

What they found

Fewer people had problems after keyhole surgery. Complications after the operation happened in 19% of the keyhole group and 27% of the open group.

The long-term picture was the same for both. After a median of 93 months, overall survival did not differ between the groups. Neither did disease-free survival, which means how long people stayed free of the cancer coming back.

Two details are worth knowing. Among people who had drug treatment before surgery, complications were about equal in both groups. And deaths within 90 days were rare either way, at 1.8% after keyhole surgery and 0.8% after open surgery.

Fewer complications usually mean a shorter hospital stay, less pain and a faster return to daily life. Because the cancer results were the same, choosing the less invasive route does not cost you anything in survival.

What is keyhole surgery?

When colorectal cancer spreads to the liver, surgery to remove those spots can cure it. Surgeons can do that through one large open incision. Or they can use laparoscopic surgery, also called keyhole surgery, working through small cuts with a camera guiding the way.

This review compared those two approaches head to head, and keyhole came out ahead on complications.

What you can do today

If you or someone close to you is facing liver surgery for colorectal cancer, write down two questions for the surgeon. First, is keyhole surgery possible in my case? The answer depends on how many spots there are and where they sit in the liver. Second, how many of these operations does your team do each year? Keep the list on your phone or in your coffee-time notebook and bring it to the next appointment.