Faculty Collaboration Database

Laparoscopic Simultaneous Resection of Colorectal Primary Tumor and Liver Metastases: Results of a Multicenter International Study. World J Surg 2015 Aug;39(8):2052-60

Date

03/31/2015

Pubmed ID

25813824

DOI

10.1007/s00268-015-3034-4

Scopus ID

2-s2.0-84937523322 (requires institutional sign-in at Scopus site)   45 Citations

Abstract

BACKGROUND: With the advance of modern laparoscopic technology, laparoscopic colorectal surgery and laparoscopic liver surgery are both worldwide accepted. Preliminary brief series have shown the feasibility of combined laparoscopic resection of colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM). We aim to report a large International multicenter series of laparoscopic simultaneous resection of CRC and SCRLM.

METHODS: Between 1997 and 2013, 142 laparoscopic liver resections were performed with simultaneous colorectal surgery for SCRLM. The surgical and postoperative variables evaluated were the duration of the intervention, blood loss, transfusion rate, conversion rate, resection margin, specific and overall morbidity, perioperative mortality, length of hospital stay, and survival. Univariate and multivariate analyses were performed examining postoperative morbidity in the all cohort of patients.

RESULTS: The median number of liver lesions was 1 (1-9) and the median larger diameter at diagnosis was 28 (2-100) mm. The median operative time was 360 (120-690) min. Seven patients (4.9%) required conversion. The global morbidity was 31.0% and the mortality was 2.1%. After a median follow-up of 29 (1-108) months, 40 patients (28.2%) developed tumor recurrence. Curative treatment of recurrence was possible in 17 patients (12.0%), including a second liver resection in 13 patients (9.1%), which was performed by laparoscopy in 7 patients (4.9%). Overall 1-, 3-, and 5-year survivals were 98.8, 82.1, and 71.9%, respectively. By multivariate analysis, ASA score≥3 [OR 13.6 (1.8-99.6); P=0.01] and operative time [OR 1.008 (1.001-1.016); P=0.03] were independent predictors of postoperative morbidity.

CONCLUSIONS: Our combined data show that in experienced centers, simultaneous laparoscopic approach is technically feasible, safe, and associated with good oncological outcomes.

Author List

Ferretti S, Tranchart H, Buell JF, Eretta C, Patriti A, Spampinato MG, Huh JW, Vigano L, Han HS, Ettorre GM, Jovine E, Gamblin TC, Belli G, Wakabayashi G, Gayet B, Dagher I

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Carcinoma
Colectomy
Colorectal Neoplasms
Feasibility Studies
Female
Hepatectomy
Humans
Laparoscopy
Length of Stay
Liver Neoplasms
Male
Middle Aged
Operative Time
Postoperative Complications
Retrospective Studies
Risk Factors