Simultaneous Hepatectomy as a Safe Approach for Synchronous Colorectal Liver Metastasis
Abstract
Material and Methods: Between; June, 2013 and June, 2019, 111 patients underwent a hepatectomy for synchronous liver metastasis, from this 90 patients received stage resection (hepatectomy alone group), and 21 patients received simultaneous resection (simultaneous resection group) with primary colorectal cancer.
Results:There were no significant differences in gender, age, primary tumor location, tumor size, number of liver metastasis, estimated blood loss, nor rate of blood transfusion. However, the hepatectomy alone group was significantly higher in the proportion of preoperative chemotherapy, compared to the simultaneous resection group (93.3 vs. 38.1%, respectively; p-value<0.001). Additionally, total operative time in the simultaneous resection group was significantly longer, when compared to the hepatectomy alone group (530 vs. 300 minutes, respectively; p-value<0.001). The length of hospital stay was also longer in the simultaneous resection group, compared to the hepatectomy alone group (10 days vs. 7 days, respectively; p-value<0.001). However, the rate of major postoperative complications were similar (14.3 vs. 10.0%; p value=0.525), respectively. Additionally, major hepatectomy and simultaneous resection were not significantly associated with any major complications.
Conclusion: Simultaneous hepatectomy in synchronous colorectal liver metastasis is a safe approach, and does not increase the risks of major complications.
Keywords
Full Text:
PDFReferences
Manfredi S, Lepage Cm, Hatem C, Coatmeur O, Faivre J, Bouvier AM. Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 2006;244:254-9.
de Santibanes E, Fernandez D, Vaccaro C, Quintana GO, Bonadeo F, Pekolj J, et al. Short-term and long-term outcomes after simultaneous resection of colorectal malignancies and synchronous liver metastases. World J Surg 2010;34:2133-40.
Tanaka K, Shimada H, Matsuo K, Nagano Y, Endo I, Sekido H, et al. Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery 2004;136:650-9.
Alexandrescu S, Diaconescu A, Ionel Z, Zlate C, Grigorie R, Hrehoret D, et al. Comparative analysis between simultaneous resection and staged resection for synchronous colorectal liver metastases - a single center experience on 300 consecutive patients. Chirurgia 2017;112:278-88.
Silberhumer GR, Paty PB, Denton B, Guillem J, Gonen M, Araujo RLC, et al. Long-term oncologic outcomes for simultaneous resection of synchronous metastatic liver and primary colorectal cancer. Surgery 2016;160:67-73.
Mayo SC, Pulitano C, Marques H, Lamelas J, Wolfgang CL, de Saussure W, et al. Surgical management of patients with synchronous colorectal liver metastasis: a multicenter international analysis. J Am Coll Surg 2013;216:707-16
Muangkaew P, Cho JY, Han HS, Yoon YS, Choi Y, Jang JY, et al. Outcomes of simultaneous major liver resection and colorectal surgery for colorectal liver metastases. J Gastrointest Surg 2016;20:554-63.
Le Souder EB, Azin A, Hirpara DH, Walker R, Cleary S, Quereshy F. Considering the cost of a simultaneous versus staged approach to resection of colorectal cancer with synchronous liver metastases in a publicly funded healthcare model. J Surg Oncol 2018;117:1376-85.
Dindo D, Demartines N, Clavien PA. Classification of Surgical Complications. Ann Surg 2004;240:205-13.
Vogt P, Raab R, Ringe B, Pichlmayr R. Resection of synchronous liver metastases from colorectal cancer. World J Surg 1991;15: 62-7.
Takorov I, Belev N, Lukanova T, Atanasov B, Dzharov G, Djurkov V, et al. Laparoscopic combined colorectal and liver resections for primary colorectal cancer with synchronous liver metastases. Ann Hepatobiliary Pancreat Surg 2016;20: 167-72.
van der Poel MJ, Tanis PJ, Marsman HA, Rijken AM, Gertsen EC, Ovaere S, et al. Laparoscopic combined resection of liver metastases and colorectal cancer: a multicenter, case matched study using propensity scores. Surg Endosc 2018; 33:1124-30.
Tranchart H, Fuks D, Vigano L, Ferretti S, Paye F, Wakabayashi G, et al. Laparoscopic simultaneous resection of colorectal primary tumor and liver metastases: a propensity score matching analysis. Surg Endosc 2016;30:1853-62.
Thelen A, Jonas S, Benckert C, Spinelli A, Lopez-Hanninen E, Rudolph B, et al. Simultaneous versus staged liver resection of synchronous liver metastases from colorectal cancer. Int J Colorectal Dis 2007;22:1269-76.
Capussotti L, Ferrero A, Vigano L, Ribero D, Lo Tesoriere R, Polastri R. Major liver resections synchronous with colorectal surgery. Ann Surg Oncol 2007;14:195-201.
Damrah O, Lykoudis PM, Orti-Rodriguez R, Pissanou T, Sharma D, Rolles K, et al. Major hepatectomy for colorectal metastases in the elderly: a tertiary center experience. Int Surg 2015;100:1276-80.
Karoui M, Penna C, Amin-Hashem M, Mitry E, Benoist S, Franc B, et al. Influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg 2006;243:1-7.
Zorzi D, Laurent A, Pawlik TM, Lauwers GY, Vauthey JN, Abdalla EK. Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases. Br J Surg 2007;94: 274-86.
Vauthey JN, Pawlik TM, Ribero D, Wu TT, Zorzi D, Hoff PM, et al. Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 2006;24:2065-72.
Wu Y, Liu F, Song W, Liang F, Wang L, Xu Y. Safety evaluation of simultaneous resection of colorectal primary tumor and liver metastasis after neoadjuvant therapy: a propensity score matching analysis. Am J Surg 2018;218: 894-8.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.