Laparoscopic Simultaneous Resection of Colorectal Primary Tumor and Liver Metastases: Results of a Multicenter International Study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-08

AUTHORS

Stefano Ferretti, Hadrien Tranchart, Joseph F. Buell, Constantino Eretta, Alberto Patriti, Marcello Giuseppe Spampinato, Jung Wook Huh, Luca Vigano, Ho Seong Han, Giuseppe Maria Ettorre, Elio Jovine, Thomas Clark Gamblin, Giulio Belli, Go Wakabayashi, Brice Gayet, Ibrahim Dagher

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. More... »

PAGES

2052-2060

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-015-3034-4

DOI

http://dx.doi.org/10.1007/s00268-015-3034-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1009633901

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25813824


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