Synchronous totally laparoscopic management of colorectal cancer and resectable liver metastases: a single center experience

Berti, Stefano; Francone, Elisa; Minuto, Michele; Bonfante, Pierfrancesco; Sagnelli, Carlo; Bianchi, Claudio; Tognoni, A.; Falcò, Emilio

doi:10.1007/s00423-015-1281-3

Cited by 21 publications

(29 citation statements)

References 40 publications

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“…Preoperative CRC diagnosis was confirmed by histology in 147 cases (data not included in the table). The SLMs diagnosis was not confirmed postoperatively in 5 cases as reported by two authors [ 10 , 22 ]. There were 101 (67.3%) cases of R0 status and 6 (4%) cases of R1 and 43 (28.7%) were the unknown status.…”

Section: Resultsmentioning

confidence: 86%

Simultaneous Minimally Invasive Treatment of Colorectal Neoplasm with Synchronous Liver Metastasis

Garritano

Selvaggi²,

Spampinato

2016

BioMed Research International

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Purpose. To analyse perioperative and oncological outcomes of minimally invasive simultaneous resection of primary colorectal neoplasm with synchronous liver metastases. Methods. A Medline revision of the current published literature on laparoscopic and robotic-assisted combined colectomy with hepatectomy for synchronous liver metastatic colorectal neoplasm was performed until February 2015. The specific search terms were “liver metastases”, “hepatic metastases”, “colorectal”, “colon”, “rectal”, “minimally invasive”, “laparoscopy”, “robotic-assisted”, “robotic colorectal and liver resection”, “synchronous”, and “simultaneous”. Results. 20 clinical reports including 150 patients who underwent minimally invasive one-stage procedure were retrospectively analysed. No randomized trials were found. The approach was laparoscopic in 139 patients (92.7%) and robotic in 11 cases (7.3%). The rectum was the most resected site of primary neoplasm (52.7%) and combined liver procedure was in 89% of cases a minor liver resection. One patient (0.7%) required conversion to open surgery. The overall morbidity and mortality rate were 18% and 1.3%, respectively. The most common complication was colorectal anastomotic leakage. Data concerning oncologic outcomes were too heterogeneous in order to gather definitive results. Conclusion. Although no prospective randomized trials are available, one-stage minimally invasive approach seems to show advantages over conventional surgery in terms of postoperative short-term course. On the contrary, more studies are required to define the oncologic values of the minimally invasive combined treatment.

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Section: Resultsmentioning

confidence: 86%

Simultaneous Minimally Invasive Treatment of Colorectal Neoplasm with Synchronous Liver Metastasis

Garritano

Selvaggi²,

Spampinato

2016

BioMed Research International

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“…The LSR group had three complications graded as Clavien‐Dindo ≤ II and four complications graded as Clavien‐Dindo ≥ III. In contrast, among patient who underwent OSR ten and five complications were Clavien‐Dindo grade ≤ II and Clavien‐Dindo grade ≥ III, respectively . Thirty‐day mortality among patients who underwent LSR was 1% (n = 2) versus 0.5% (n = 1) for patients who underwent OSR.…”

Section: Resultsmentioning

confidence: 89%

“…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%

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

Moris

Tsilimigras

Machairas

et al. 2018

Journal of Surgical Oncology

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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 |

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“…Presently, many descriptive series are available, including a still limited number of cases [24,[34][35][36][37][38], probably because an adequate experience in laparoscopic surgery of both districts is required and this factor limits widespread diffusion of this technique.…”

Section: Discussionmentioning

confidence: 98%

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

et al. 2016

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Synchronous totally laparoscopic management of colorectal cancer and resectable liver metastases: a single center experience

Abstract: This series confirms the feasibility of synchronous laparoscopic colorectal and hepatic resections. To ensure the best outcomes, a careful selection of patients is needed. However, most patients can benefit from this surgical approach.

Cited by 21 publications

References 40 publications

Simultaneous Minimally Invasive Treatment of Colorectal Neoplasm with Synchronous Liver Metastasis

Simultaneous Minimally Invasive Treatment of Colorectal Neoplasm with Synchronous Liver Metastasis

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

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

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