Objective To compare the safety and efficacy of repeat laparoscopic liver resection (LLR) and open liver resection (OLR) for patients with colorectal cancer liver metastasis (CRLM).

Methods A total of 289 patients with CRLM undergoing curative resection from January 2011 to December 2019 were enrolled and divided into LLR group (n=40) and OLR group (n=249). Propensity score matching (PSM) was performed as 1:2 in the LLR and OLR groups. The perioperative outcomes were compared between the two groups.

Results There was no perioperative death in the two groups. There was no statistically significant difference in blood transfusion rate, porta hepatis block time, and unplanned readmission rate within 30 days after surgery. After PSM, 40 patients in the LLR group and 80 patients in the OLR group were included. Compared with the patients in the OLR group, the intraoperative bleeding was less (50 mL vs 200 mL, P=0.001), the postoperative complication rate was lower (25.0% vs 47.5%, P=0.030), and the postoperative hospital stay was shorter (6 d vs 7 d; P=0.009) in the LLR group.

Conclusions CRLM patients who receive repeat LLR have better perioperative outcomes than those who receive repeat OLR.