Efficacy of the Predicted Operation Time (POT) Strategy for Synchronous Colorectal Liver Metastasis (SCLM): Feasibility Study for Staged Resection in ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-04

AUTHORS

Kentaro Nakajima, Shinichiro Takahashi, Norio Saito, Masanori Sugito, Masaru Konishi, Takahiro Kinoshita, Naoto Gotohda, Yuichiro Kato

ABSTRACT

BACKGROUND: The optimal surgical strategy for resectable synchronous colorectal liver metastases (SCLM), whether simultaneous or staged resections, still remains obscure. The aim of this study was to assess the efficacy of the predicted operation time (POT) strategy, which recommends staged resections in case of POT ≥6 h, otherwise selecting simultaneous resection. METHODS: This was a prospective, nonrandomized, single-institution study. Fifty-nine patients with SCLM underwent tumor resection according to the POT strategy, with patients with a longer POT (≥6 h) undergoing staged resection. Morbidity, overall hospitalization, tumor resection rates, and survival were compared with that of 86 patients who underwent simultaneous resection for SCLM irrespective of POT from 1992 to 2004. RESULTS: The former simultaneous and the latter POT strategy groups were similar in terms of patient and tumor demographics as well as surgical procedures. Of the 59 POT group patients, 26 patients (44 %) experienced 40 postoperative complications. Comparing the surgical results of simultaneous resection from 1992 to 2004 and those of resection according to the POT strategy, morbidity (64 vs. 44 %, p = 0.02), frequency of anastomotic leakage (21 vs. 5 %, p < 0.01), and length of hospital stay (27 vs. 18 days, p < 0.01) were significantly lower in the latter group, while tumor resection rates (85 vs. 87 %, p = 0.77) were not different. CONCLUSIONS: The POT strategy is effective in reducing the morbidity in SCLM patients by selecting staged resections in the high-morbidity-risk group without adverse effects on oncologic outcome. More... »

PAGES

688-695

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-013-2163-z

DOI

http://dx.doi.org/10.1007/s11605-013-2163-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052681507

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23404172


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39 schema:description BACKGROUND: The optimal surgical strategy for resectable synchronous colorectal liver metastases (SCLM), whether simultaneous or staged resections, still remains obscure. The aim of this study was to assess the efficacy of the predicted operation time (POT) strategy, which recommends staged resections in case of POT ≥6 h, otherwise selecting simultaneous resection. METHODS: This was a prospective, nonrandomized, single-institution study. Fifty-nine patients with SCLM underwent tumor resection according to the POT strategy, with patients with a longer POT (≥6 h) undergoing staged resection. Morbidity, overall hospitalization, tumor resection rates, and survival were compared with that of 86 patients who underwent simultaneous resection for SCLM irrespective of POT from 1992 to 2004. RESULTS: The former simultaneous and the latter POT strategy groups were similar in terms of patient and tumor demographics as well as surgical procedures. Of the 59 POT group patients, 26 patients (44 %) experienced 40 postoperative complications. Comparing the surgical results of simultaneous resection from 1992 to 2004 and those of resection according to the POT strategy, morbidity (64 vs. 44 %, p = 0.02), frequency of anastomotic leakage (21 vs. 5 %, p < 0.01), and length of hospital stay (27 vs. 18 days, p < 0.01) were significantly lower in the latter group, while tumor resection rates (85 vs. 87 %, p = 0.77) were not different. CONCLUSIONS: The POT strategy is effective in reducing the morbidity in SCLM patients by selecting staged resections in the high-morbidity-risk group without adverse effects on oncologic outcome.
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