Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis

Ratti, Francesca; Catena, Marco; Palo, S. Di; Staudacher, C.; Aldrighetti, Luca

doi:10.1007/s00464-016-4835-8

Cited by 44 publications

(39 citation statements)

References 43 publications

(97 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…64 e 2016AustraliaPropensity scoreLLR14663.05NANANAPartial36NA5OLR14061.35NANANAHLR andhybridRatti et al . 65 e 2016ItalyPropensity scoreLLR2560 (37–80)14/112.9 (0.5–11)2 (1–6)LLR37 (15–75)1 (4)5OLR5062 (35–81)27/233.4 (0.9–12)2 (1–7)Tranchart et al . 66 e 2016JapanPropensity scoreLLR8966.6 ± 10.847/422.9 ± 1.91.4 ± 0.6Partial26 (1–94)6 (7)5OLR8965.0 ± 9.449/402.8 ± 2.01.5 ± 0.7HLR26 (1–100)Untereiner et al .…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

Xie

Xiong

Liu

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The effects of laparoscopic liver resection (LLR) and open liver resection (OLR) on oncological outcomes for colorectal cancer liver metastases (CCLM) remain inconclusive. Major databases were searched from January 1992 to October 2016. Effects of LLR vs OLR were determined. The primary endpoints were oncological outcomes. In total, 32 eligible non-randomized studies with 4697 patients (LLR: 1809, OLR: 2888) were analyzed. There were higher rates of clear surgical margins (OR: 1.64, 95%CI: 1.32 to 2.05, p < 0.00001) in the LLR group, without significant differences in disease recurrence, 3- or 5-year overall survival(OS) and disease free survival(DFS) between the two approaches. LLR was associated with less intraoperative blood loss (WMD: −147.46 [−195.78 to −99.15] mL, P < 0.00001) and fewer blood transfusions (OR: 0.41 [0.30–0.58], P < 0.00001), but with longer operation time (WMD:14.44 [1.01 to 27.88] min, P < 0.00001) compared to OLR. Less overall morbidity (OR: 0.64 [0.55 to 0.75], p < 0.00001) and shorter postoperative hospital stay (WMD: −2.36 [−3.06 to −1.66] d, p < 0.00001) were observed for patients undergoing LLR, while there was no statistical difference in mortality. LLR appears to be a safe and feasible alternative to OLR in the treatment of CCLM in selected patients.

show abstract

Section: Resultsmentioning

confidence: 99%

Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

Xie

Xiong

Liu

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…In consideration of the influence of adjuvant chemotherapy on the overall survival and disease-free survival, the administration of postoperative chemotherapy was comparable between the laparoscopic and open groups in nine studies, while the remaining three studies [ 21 , 24 , 25 ] did not report the details about postoperative chemotherapy. Therefore, we did a sensitivity analysis by removing those three studies, and the results were consistent with original outcomes (overall survival: 1 year, 0.54 (95% CI 0.16–1.59; 5 years, 0.66 (95% CI 0.16–2.69); disease-free survival: 1 year, 1.31 (95% CI 0.50–3.41); 3 years, 0.80 (95% CI 0.34–1.86)).…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic procedure is associated with lower morbidity for simultaneous resection of colorectal cancer and liver metastases: an updated meta-analysis

Long

Tong

et al. 2020

World J Surg Onc

View full text Add to dashboard Cite

Background It has been demonstrated that simultaneous resection of both primary colorectal lesion and metastatic hepatic lesion is a safe approach with low mortality and postoperative complication rates. However, there are some controversies over which kind of surgical approach is better. The aim of study was to compare the efficacy and safety of laparoscopic surgeries and open surgeries for simultaneous resection of colorectal cancer (CRC) and synchronous colorectal liver metastasis (SCRLM). Methods A systemic search of online database including PubMed, Web of Science, Cochrane Library, and Embase was performed until June 5, 2019. Intraoperative complications, postoperative complications, and long-term outcomes were synthesized by using STATA, version 15.0. Cumulative and single-arm meta-analyses were also conducted. Results It contained twelve studies with 616 patients (273 vs 343, laparoscopic surgery group and open surgery group, respectively) and manifested latest surgical results for the treatment of CRC and SCRLM. Among patients who underwent laparoscopic surgeries, they had lower rates of postoperative complications (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028), less intraoperative blood loss (weight mean difference (WMD) = − 113.31, 95% CI: − 189.03 to − 37.59, P = 0.003), less time in the hospital and recovering after surgeries (WMD = − 2.70, 95% CI: − 3.99 to − 1.40, P = 0.000; WMD = − 3.20, 95% CI: − 5.06 to − 1.34, P = 0.001), but more operating time (WMD = 36.57, 95% CI: 7.80 to 65.35, P = 0.013). Additionally, there were no statistical significance between two kinds of surgical approaches in disease-free survival and overall survival. Moreover, cumulative meta-analysis indicated statistical difference in favor of laparoscopic surgery in terms of morbidity was firstly detected in the 12th study in 2018 (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028) as the 95% CI narrowed. Conclusion Compared with open surgeries, laparoscopic surgeries are safer (postoperative complications and intraoperative blood loss) and more effective (length of hospital stay and postoperative stay), and it can be considered as the first option for management of SCRLM in high-volume laparoscopic centers. Trial registration CRD42020151176

show abstract

“…However, the intraoperative blood loss was less in the MIS group than in the OS group (WMD = -130.09, 95%CI: -210.95 to -49.23, P = 0.002, I 2 = 91% for heterogeneity, P < 0.00001; Figure 2B). Seven studies reported the number of intraoperative blood transfusions in 407 patients[24-27,29-31]. The number of intraoperative blood transfusions was significantly less in the MIS group than in the OS group (OR = 0.53, 95%CI: 0.29 to 0.95, P = 0.03, I 2 = 0% for heterogeneity, P = 0.81; Figure 2C).…”

Section: Resultsmentioning

confidence: 99%

“…In this meta-analysis, postoperative outcomes included the time to bowel functional recovery, time to start diet, length of postoperative hospital stay, and postoperative complications. Five studies reported the time to bowel functional recovery in 222 patients[23,24,26,30,31]. The pooled mean time to bowel functional recovery was shorter in the MIS group than in the OS group (WMD = -0.88 d, 95%CI: -1.58 to -0.19, P = 0.01, I 2 = 94% for heterogeneity, P < 0.00001; Figure 2D).…”

Section: Resultsmentioning

confidence: 99%

Mini-invasive vs open resection of colorectal cancer and liver metastases: A meta-analysis

Ye¹,

Qiu²,

Liao³

et al. 2019

WJG

View full text Add to dashboard Cite

BACKGROUND The safety and feasibility of the simultaneous resection of primary colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM) have been demonstrated in some studies. Combined resection is expected to be the optimal strategy for patients with CRC and SCRLM. However, traditional laparotomy is traumatic, and the treatment outcome of minimally invasive surgery (MIS) is still obscure. AIM To compare the treatment outcomes of MIS and open surgery (OS) for the simultaneous resection of CRC and SCRLM. METHODS A systematic search through December 22, 2018 was conducted in electronic databases (PubMed, EMBASE, Web of Science, and Cochrane Library). All studies comparing the clinical outcomes of MIS and OS for patients with CRC and SCRLM were included by eligibility criteria. The meta-analysis was performed using Review Manager Software. The quality of the pooled study was assessed using the Newcastle-Ottawa scale. The publication bias was evaluated by a funnel plot and the Begg’s and Egger’s tests. Fixed- and random-effects models were applied according to heterogeneity. RESULTS Ten retrospective cohort studies involving 502 patients (216 patients in the MIS group and 286 patients in the OS group) were included in this study. MIS was associated with less intraoperative blood loss [weighted mean difference (WMD) = -130.09, 95% confidence interval (CI): -210.95 to -49.23, P = 0.002] and blood transfusion [odds ratio (OR) = 0.53, 95%CI: 0.29 to 0.95, P = 0.03], faster recovery of intestinal function (WMD = -0.88 d, 95%CI: -1.58 to -0.19, P = 0.01) and diet (WMD = -1.54 d, 95%CI: -2.30 to -0.78, P < 0.0001), shorter length of postoperative hospital stay (WMD = -4.06 d, 95%CI: -5.95 to -2.18, P < 0.0001), and lower rates of surgical complications (OR = 0.60, 95%CI: 0.37 to 0.99, P = 0.04). However, the operation time, rates and severity of overall complications, and rates of general complications showed no significant differences between the MIS and OS groups. Moreover, the overall survival and disease-free survival after MIS were equivalent to those after OS. CONCLUSION Considering the studies included in this meta-analysis, MIS is a safe and effective alternative technique for the simultaneous resection of CRC and SCRLM. Compared with OS, MIS has less intraoperative blood loss and blood transfusion and quicker postoperative recovery. Furthermore, the two groups show equivalent long-term outcomes.

show abstract

Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis

Abstract: TLA for combined resections is feasible, and its indications can be widened to encompass a larger population of patients, provided its benefits in terms of reduced overall risk and severity of complications, rapid functional recovery and favorable long-term outcomes.

Cited by 44 publications

References 43 publications

Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

Laparoscopic Versus Open Liver Resection for Colorectal Liver Metastases: A Comprehensive Systematic Review and Meta-analysis

Laparoscopic procedure is associated with lower morbidity for simultaneous resection of colorectal cancer and liver metastases: an updated meta-analysis

Mini-invasive vs open resection of colorectal cancer and liver metastases: A meta-analysis

Contact Info

Product

Resources

About