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

Abstract

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.

RETRACTED: Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

“…A total of 2,534 unique studies were identified, of which 13 studies (between 2011 and 2021) fulfilled the inclusion criteria and were included in the study (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

“…This meta-analysis study based on 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time, less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival compared to open surgery (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31).…”

“…This meta-analysis study based on 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time, less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival compared to open surgery (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Though, the analysis of outcomes should be done with caution because of the low sample size of most of the selected studies (10 studies were ≤100 subjects) in the meta-analysis especially in some parameters; suggesting the need for more studies comparing minimally invasive surgery to open surgery in subjects with colorectal cancer and synchronous colorectal liver metastases to validate these findings or possibly to significantly influence confidence in the effect evaluation.…”

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

“…Several reports assessed the short-term outcome of hepatic and colorectal SLR showing a similar or inferior blood loss, a similar or lower complication rate, and an important reduction of hospital stay for laparoscopic surgery respect to open surgery. On the contrary, longer operating times of laparoscopic surgery are generally reported (34,(50)(51)(52)(53)(54)(55)(56) even though in some referral centers shorter operative times are also registered (57,58). The long-term outcomes are also comparable with the previously described cases of abdominal metastases especially at port sites (59,60).…”

Comparison of laparoscopic and open simultaneous surgeries for synchronous metastases of colorectal cancer in the liver: meta-analysis

“…С развитием технического оснащения в хирургию стали активно внедрять лапароскопичес кий способ хирургического вмешательства, выделив такие преимущества, как ранняя активизация больного, уменьшение травмы и стресса [10][11][12]. В настоящее время нет однозначного мнения о превосходстве непосредственных и отдаленных результатов симультанных лапароскопических операций.…”