Laparoscopic Simultaneous Resection of Colorectal Primary Tumor and Liver Metastases: Results of a Multicenter International Study

Abstract

Our combined data show that in experienced centers, simultaneous laparoscopic approach is technically feasible, safe, and associated with good oncological outcomes.

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

“…This complication rate was not different from the rates reported in large series of isolated colorectal resections [39] or open combined resections [11]. In addition, they found that ASA score C3 and global operative time were independent predictors of postoperative complications [21]. Even in the comparative study between totally laparoscopic and totally open combined resections by Jung et al [22], a significant advantage in terms of postoperative events was not found in patients scheduled for minimally invasive approach, in spite of a trend toward reduced morbidity rate (17 vs 42 % in open group).…”

“…Furthermore, more recently even safety and efficacy of combined resections have been reported [7][8][9][10][11], with shorter length of stay and reduced morbidity compared with staged approaches if performed in a selected population of patients [6][7][8]. Although the debate regarding the optimal timing for resection of SCLM is still open [6][7][8], mainly because of concerns regarding a presumptive higher frequency of colonic anastomosis leakage, even combined, totally laparoscopic approach for CRC and SCLM is experiencing a growing trend [21][22][23][24].…”

“…In 2015, Ferretti et al [21] published the largest series of combined TLA resections, including 142 procedures performed in 14 centers worldwide: The morbidity rate was 31.0 %, without differences between liver-specific and colorectal-specific complications. This complication rate was not different from the rates reported in large series of isolated colorectal resections [39] or open combined resections [11].…”

“…In this setting, the possibility of a totally laparoscopic approach (TLA) in combined resection of primary cancer and resectable SCLM represents an attracting option, possibly reducing complications correlated with extended laparotomy and with enhanced biological stress. Even though feasibility of TLA has been reported in the literature [21][22][23][24], no definite conclusions regarding indications and outcomes have been drawn so far.…”

Laparoscopic simultaneous resection of colorectal primary tumor and liver metastases: a propensity score matching analysis

“…All centers involved in this study have more than 4 years of experience in the liver and colorectal laparoscopic surgical field, and characteristics of patients involved in this database were previously reported [27]. Those laparoscopic patients were compared to all consecutive patients that underwent open liver resection with combined open resection of CRC and SCRLM at Mauriziano Umberto I (Turin, Italy) and at Saint Antoine Hospital (Paris, France) during the study period.…”