Laparoscopic versus open 1-stage resection of synchronous liver metastases and primary colorectal cancer

Görgün, Emre; Yazici, Pınar; Önder, Akın; Benlice, Çiğdem; Yiğitbaş, Hakan; Kahramangil, Bora; Taşçı, Yunus; Aksoy, Erol; Aucejo, Federico; Quintini, Cristiano; Miller, Charles M.; Berber, Eren

doi:10.21037/gs.2017.03.10

Cited by 15 publications

(32 citation statements)

References 21 publications

(27 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast, one study noted shorter operative times for the laparoscopic group ( P < 0.05) . EBL was lower in the LSR group compared with the OSR group in four studies ( P < 0.05), while the other four studies reported no difference in EBL between OLR and LSR . Two cases of conversion from laparoscopic to open approach were reported.…”

Section: Resultsmentioning

confidence: 86%

“…Postoperative morbidity was 19.9% (n = 27/136) in the LSR group compared with 32.8% (n = 56/171) in the OSR group. There were no differences in the incidence of complications among patients undergoing LSR versus OR except for the study by Gorgun et al that noted higher overall complications in the OSR group ( P = 0.016). Only two comparative studies included classification of postoperative complications according to the Clavien‐Dindo system (Table ) .…”

Section: Resultsmentioning

confidence: 86%

“…Two of the comparative studies reported longer operative time for patients who underwent laparoscopic procedures versus patients who underwent open resection ( P < 0.03), whereas five studies reported no difference in operative times among the two groups . In contrast, one study noted shorter operative times for the laparoscopic group ( P < 0.05) .…”

Section: Resultsmentioning

confidence: 95%

“…Two cases of conversion from laparoscopic to open approach were reported. Of note, patients who underwent LSR had a shorter LOS compared with patients undergoing OSR in each study, except for one study …”

Section: Resultsmentioning

confidence: 96%

“…A total of 12 studies that included patients who underwent LSR of the primary colorectal tumor and CRLM were considered eligible; while four studies were noncomparative (n = 63 patients), the remaining eight studies were comparative and analyzed postoperative outcomes of 136 patients who underwent LSR versus 171 patients who underwent OSR . The indices analyzed were tabulated in three structured tables as follows: patient characteristics (Table ), operative details (Table ), and long‐term outcomes (Table ).…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review

Moris

Tsilimigras

Machairas

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

While colorectal and hepatic resections are commonly performed through a laparoscopic approach, the safety and feasibility of total laparoscopic synchronous resections (LSR) of colorectal liver metastasis (CRLM) have not been established. In this systematic review, short-and long-term outcomes were comparable for patientsundergoing LSR and open synchronous resection. LSR was safe and feasible for patients with synchronous CRLM and should be considered in well-selected patients. K E Y W O R D S colorectal cancer, combined resection, laparoscopy, liver metastasis, synchronous resection 1 | INTRODUCTION Colorectal cancer (CRC) is the third leading cause of cancerrelated deaths in the United States. In 2017, approximately 140 000 new cases of CRC were diagnosed with over 50 000 cancer-related deaths. 1 The liver is the most common site of metastases with 15% to 25% of patients presenting with synchronous colorectal liver metastases (CRLM) at the time of diagnosis. 2,3 Modern chemotherapy has resulted in improved response and survival rates for patients with liver metastases and has also increased the rate of resectability of CRLM in selected patients as part of a comprehensive multidisciplinary treatment strategy. In turn, resection of CRLM is now associated with 5-year survival greater than 50%. 4,5Among patients with resectable disease, surgical resection remains the only potentially curative treatment for synchronous CRLM. 4 However, the optimal operative sequence for the management of the primary tumor and metastatic liver disease remains unclear. 6 The traditional surgical strategy consists of a staged approach, in which resection of the primary tumorwith or without adjuvant chemotherapyis followed by a planned liver resection at a future date (colorectal-first approach). Alternatively, the "reverse approach" consists of resection of liver metastases before removal of the primary tumor (liver-first approach). With improvements in surgical technique and perioperative care over the past two decades, an increasing number of patients are being managed through a combined approach comprised of synchronous resection of the primary colorectal tumor and liver metastases. 7,8 Several studies have demonstrated the safety, efficacy, and feasibility of open synchronous resections (OSR), with acceptable morbidity, mortality, and long-term outcomes. 7,9,10 Furthermore, synchronous resection (SR) may offer several potential benefits for patients, including shorter overall hospital LOS, reduced costs, and the need to recover from only one major operation, while providing equivalent oncologic outcomes. 11,12 J Surg Oncol. 2019;119:30-39. wileyonlinelibrary.com/journal/jso 30 |

show abstract

Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 86%

Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review

Moris

Tsilimigras

Machairas

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

Laparoscopic Liver Resection Technique: French Experience

Salloum

Cherqui

2022

Colorectal Liver Metastasis

View full text Add to dashboard Cite

Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis

Morărașu

Clancy

Görgün

et al. 2023

Int J Colorectal Dis

Self Cite

View full text Add to dashboard Cite

Purpose Combined resection of primary colorectal cancer and associated liver metastases is increasingly common. This study compares peri-operative and oncological outcomes according to surgical approach. Methods The study was registered with PROSPERO. A systematic search was performed for all comparative studies describing outcomes in patients that underwent laparoscopic versus open simultaneous resection of colorectal primary tumours and liver metastases. Data was extracted and analysed using a random effects model via Rev Man 5.3 Results Twenty studies were included with a total of 2168 patients. A laparoscopic approach was performed in 620 patients and an open approach in 872. There was no difference in the groups for BMI (mean difference: 0.04, 95% CI: 0.63–0.70, p = 0.91), number of difficult liver segments (mean difference: 0.64, 95% CI:0.33–1.23, p = 0.18) or major liver resections (mean difference: 0.96, 95% CI: 0.69–1.35, p = 0.83). There were fewer liver lesions per operation in the laparoscopic group (mean difference 0.46, 95% CI: 0.13–0.79, p = 0.007). Laparoscopic surgery was associated with shorter length of stay (p < 0.00001) and less overall postoperative complications (p = 0.0002). There were similar R0 resection rates (p = 0.15) but less disease recurrence in the laparoscopic group (mean difference: 0.57, 95% CI:0.44–0.75, p < 0.0001). Conclusion Synchronous laparoscopic resection of primary colorectal cancers and liver metastases is a feasible approach in selected patients and does not demonstrate inferior peri-operative or oncological outcomes.

show abstract

Laparoscopic versus open 1-stage resection of synchronous liver metastases and primary colorectal cancer

Cited by 15 publications

References 21 publications

Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review

Laparoscopic synchronous resection of colorectal cancer and liver metastases: A systematic review

Laparoscopic Liver Resection Technique: French Experience

Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis

Contact Info

Product

Resources

About