Laparoscopic combined resection of liver metastases and colorectal cancer: a multicenter, case-matched study using propensity scores

Poel, Marcel J. van der; Tanis, Pieter J.; Marsman, Hendrik A.; Rijken, Arjen M.; Gertsen, Emma C.; Ovaere, Sander; Gerhards, Michael F.; Besselink, Marc G.; D’Hondt, Mathieu; Gobardhan, Paul D.

doi:10.1007/s00464-018-6371-1

Cited by 14 publications

(10 citation statements)

References 31 publications

(28 reference statements)

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“…to laparoscopic colorectal surgery alone; with carefully selected patients, especially those who require a minor hepatectomy. [11][12][13] In our study, over 30.0% of the simultaneous group underwent treatment via laparoscopic fashion, which showed no increased risk of major complications. Major hepatectomies, classified as a hepatectomy with at least three segments, is usually associated with more surgical complications.…”

Section: Discussionmentioning

confidence: 49%

Simultaneous Hepatectomy as a Safe Approach for Synchronous Colorectal Liver Metastasis

Thongkan

Wiboonkhwan

Pitakteerabundit

et al. 2020

J Health Sci Med Res

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Objective: The optimal surgical strategy for treatment of colorectal cancer with synchronous liver metastasis remains controversial. This retrospective analysis compared both surgical and perioperative outcomes for patients receiving simultaneous hepatectomy and primary colorectal surgery, to those receiving hepatectomy alone for stage approach. Material and Methods: Between; June, 2013 and June, 2019, 111 patients underwent a hepatectomy for synchronous liver metastasis, from this 90 patients received stage resection (hepatectomy alone group), and 21 patients received simultaneous resection (simultaneous resection group) with primary colorectal cancer. Results:There were no significant differences in gender, age, primary tumor location, tumor size, number of liver metastasis, estimated blood loss, nor rate of blood transfusion. However, the hepatectomy alone group was significantly higher in the proportion of preoperative chemotherapy, compared to the simultaneous resection group (93.3 vs. 38.1%, respectively; p-value<0.001). Additionally, total operative time in the simultaneous resection group was significantly longer, when compared to the hepatectomy alone group (530 vs. 300 minutes, respectively; p-value<0.001). The length of hospital stay was also longer in the simultaneous resection group, compared to the hepatectomy alone group (10 days vs. 7 days, respectively; p-value<0.001). However, the rate of major postoperative complications were similar (14.3 vs. 10.0%; p value=0.525), respectively. Additionally, major hepatectomy and simultaneous resection were not significantly associated with any major complications. Conclusion: Simultaneous hepatectomy in synchronous colorectal liver metastasis is a safe approach, and does not increase the risks of major complications.

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Section: Discussionmentioning

confidence: 49%

Simultaneous Hepatectomy as a Safe Approach for Synchronous Colorectal Liver Metastasis

Thongkan

Wiboonkhwan

Pitakteerabundit

et al. 2020

J Health Sci Med Res

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“…Recently, minimally invasive surgery of colorectal resection and liver resection particularly minor liver resection have been accepted as standard treatment. However, few studies reported feasibility and surgical outcomes of simultaneous laparoscopic surgery of these two procedures [ [6] , [7] , [8] ].…”

Section: Introductionmentioning

confidence: 99%

Benefits of simultaneous laparoscopic colorectal surgery and liver resection for colorectal cancer with synchronous liver metastases: Retrospective case-matched study

Taesombat

Kanjanasilp

Nonthasoot

et al. 2020

Annals of Medicine and Surgery

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Introduction Laparoscopic surgery for colorectal cancer and liver tumors are accepted as alternative procedure to open surgery. However, few studies reported outcomes of simultaneous laparoscopic surgery of these two procedures. The aim of this study was to compare short-term outcomes between laparoscopic and open approach. Materials and methods Between June 2010 to December 2019, simultaneous laparoscopic cases were retrospectively matched (1:2) to open cases. Peri-operative and short-term outcomes were compared between both groups. Results Twelve patients in laparoscopic group were matched to 24 patients in open group according to age, gender, body mass index, american society of anesthesiologists physical status, preoperative laboratory data, number and size of liver metastases and extent of colorectal and liver resection, Most patients in each group had left-sided colon or rectal cancer and underwent wedge liver resection. The mean number of liver metastases was 1.3 vs 1.5 and size of liver metastases was 2.2 ± 1.4 vs 2.7 ± 1.1 cm in laparoscopic compared to open group. Estimated blood loss and length of hospital stay were significantly lower in laparoscopic group. However, operative time was significantly longer in laparoscopic group. Peri-operative complication was not significant difference between both groups and there was no mortality. Conclusion Simultaneous laparoscopic colorectal surgery and minor liver resection is feasible and safe. Laparoscopic approach has better peri-operative outcome in term of shorter length of hospital stay compared to open approach.

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“…Many other retrospective studies that compared long term outcomes of laparoscopic one stage surgery with open one stage surgery did not identify differences in OS ( 30 , 33 ) but only a slight difference in terms of DFS.…”

Section: Discussionmentioning

confidence: 89%

“…The placement of the trocars depends on the type of resection that will be performed ( Figures 2 , 3 ) ( 31 , 32 ) and the surgical steps are performed as described by other authors ( 33 , 34 ) ( Figure 4 ).…”

Section: Surgical Techniquementioning

confidence: 99%

One-Stage Total Laparoscopic Treatment for Colorectal Cancer With Synchronous Metastasis. Is It Safe and Feasible?

et al. 2021

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Liver is the main target organ for colorectal cancer (CRC) metastases. It is estimated that ~25% of CRC patients have synchronous metastases at diagnosis, and about 60% of CRC patients will develop metastases during the follow up. Although several teams have performed simultaneous laparoscopic resections (SLR) of liver and colorectal lesions, the feasibility and safety of this approach is still widely debated and few studies on this topic are present in the literature. The purpose of this literature review is to understand the state of the art of SLR and to clarify the potential benefits and limitations of this approach. Several studies have shown that SLR can be performed safely and with short-term outcomes similarly to the separated procedures. Simultaneous laparoscopic colorectal and hepatic resections combine the advantages of one stage surgery with those of laparoscopic surgery. Several reports compared the short-term outcomes of one stage laparoscopic resection with open resections and showed a similar or inferior amount of blood loss, a similar or lower complication rate, and a significant reduction of hospital stay for laparoscopic surgery respect to open surgery but much longer operating times for the laparoscopic technique. Few retrospective studies compared long term outcomes of laparoscopic one stage surgery with the outcomes of open one stage surgery and did not identify any differences about disease free survival and the overall survival. In conclusion, hepatic and colorectal SLR are a safe and effective approach characterized by less intraoperative blood loss, faster recovery of intestinal function, and shorter length of postoperative hospital stay. Moreover, laparoscopic approach is associated to lower rates of surgical complications without significant differences in the long-term outcomes compared to the open surgery.

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Laparoscopic combined resection of liver metastases and colorectal cancer: a multicenter, case-matched study using propensity scores

Abstract: In selected patients requiring minor hepatectomy, LLCR can be safely performed without increasing the risk of postoperative morbidity compared to LCR alone.

Cited by 14 publications

References 31 publications

Simultaneous Hepatectomy as a Safe Approach for Synchronous Colorectal Liver Metastasis

Simultaneous Hepatectomy as a Safe Approach for Synchronous Colorectal Liver Metastasis

Benefits of simultaneous laparoscopic colorectal surgery and liver resection for colorectal cancer with synchronous liver metastases: Retrospective case-matched study

One-Stage Total Laparoscopic Treatment for Colorectal Cancer With Synchronous Metastasis. Is It Safe and Feasible?

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