Laparoscopic Versus Open Simultaneous Resection of Primary Colorectal Cancer and Associated Liver Metastases: A Comparative Retrospective Study

Abstract

The aim was to compare the short-term and long-term outcomes of patients with metastatic colorectal cancer (CRC) undergoing laparoscopic versus open colorectal resection with simultaneous resection for liver metastases. Currently there is a lack of studies that have investigated the oncosurgical aspects and the short and long-term outcomes from these procedures. Materials and Methods:A retrospective study of patients who underwent simultaneous resections for CRC and synchronous liver metastases between 2008 and 2019 in 2 university affiliated medical centers.Results: Sixty-three patients were identified of whom 21 had successful laparoscopic simultaneous resections. In 43% of patients, the primary tumor was located in the right colon. The 3-year overall survival and disease-free survival rates were 87% and 48%, respectively. When compared with a separate control group of 42 patients who underwent conventional open resections, the laparoscopic approach was associated with an increased operative time (286 vs. 225 min, P = 0.05), but a shorter hospital stay (6 vs. 8 d, P = 0.008).Conclusions: Simultaneous laparoscopic colorectal and parenchymal sparing liver resection for metastatic CRC is safe, feasible, and it is a preferable approach because of better short-term outcome compared with open surgery while not compromising survival and disease recurrence.

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

“…Fourteen studies [ 17 – 28 , 30 , 35 ] describing 1165 patients included data on patients BMI. There was no difference in BMI between the 2 groups (mean difference: 0.04, 95% CI: [0.63, 0.70], p = 0.91, Chi 2 = 77.81, I 2 = 83%) (Fig.…”

“…Ten studies [ 18 , 19 , 23 – 26 , 28 – 30 , 35 ] including 720 patients reported the mean number of liver lesions for each group. There were statistically fewer lesions in the LAP group with a mean difference of 0.46, 95% CI: [0.13, 0.79], p = 0.007, Chi 2 = 58.86, I 2 = 85% (Fig.…”

“…Nine studies [ 18 , 22 – 26 , 28 – 30 ] analysed the number of R0 liver resections in each group. There was no significant difference and heterogeneity in terms of R0 resections (OR: 1.48, 95% CI: [0.86, 2.55], p = 0.15, Chi 2 = 6.50, I 2 = 0%) (Fig.…”

“…Eleven studies [ 17 , 18 , 24 – 31 , 35 ] had descriptive, numerical data on the number of recurrences in each group at a three-year interval. Six studies [ 17 , 18 , 26 , 28 , 29 , 35 ] specified the site of recurrence, with liver being the most common location. The forest plot showed significantly fewer overall recurrences in the LAP group (OR: 0.57, 95% CI: [0.44, 0.75], p < 0.0001, Chi 2 = 9.85, I 2 = 0%) (Fig.…”