Impact on operative outcomes of laparoscopic simultaneous resection of colorectal cancer and synchronous liver metastases

Abstract

Introduction The efficacy of laparoscopic simultaneous resection of primary colorectal cancer and synchronous colorectal liver metastases (SCRLM) remains unclear. Methods We retrospectively evaluated data from 258 patients who had undergone simultaneous curative resection of the primary tumor and SCRLM from 2006 to 2017. We compared surgical outcomes between open, hybrid (laparoscopic colorectal resection and open hepatectomy), and pure laparoscopic approaches. Surgical outcomes were also evaluated between the open hepatectomy (OH) group (ie, open/hybrid surgery) and the laparoscopic hepatectomy (LH) group (ie, pure laparoscopic surgery) in 141 patients later in the study period (2013‐2017), when the clinical indications for laparoscopic hepatectomy were restricted to simple wedge resection and/or left lateral sectionectomy in our center. Results The pure laparoscopic approach was associated with significantly less intraoperative blood loss and a significantly shorter postoperative hospital stay than the open and hybrid approaches. Late in the study period, operative outcomes in the LH group (n = 37) were more favorable than for the OH group (n = 104) in terms of intraoperative blood loss and postoperative hospital stay. In patients with rectal cancer, however, earlier postoperative recovery in the LH group did not differ significantly from the OH group. Conclusion Laparoscopic simultaneous resection of SCRLM with the primary tumor by simple hepatectomy is safe and may enhance patients' postoperative recovery, especially in patients with colon cancer.

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).…”

The Value of Laparoscopic Simultaneous Colorectal and Hepatic Resection for Synchronous Colorectal Cancer Liver Metastasis: A Propensity Score Matching Study

“…After 2014, related studies were gradually increasing. In these previous studies, advances in perioperative safety and short-term outcomes, including intraoperative blood loss, postoperative hospital stay, and postoperative morbidity, were observed in the total laparoscopic simultaneous resection approach (15,18,(23)(24)(25)(26)(27). Although these advantages seemed unstable and could not be observed in all studies (14), both long-term OS and RFS were not compromised.…”