Original CommunicationEvaluation of the safety and efficacy of simultaneous resection of primary colorectal cancer and synchronous colorectal liver metastases
Section snippets
Patients
With prospectively collected data from the Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, University of Tokyo (Tokyo, Japan), we identified a total of 425 patients who underwent initial hepatectomy for colorectal liver metastases from January 1993 to December 2011. Of these 425 patients, we reviewed 150 consecutive patients who underwent macroscopically curative resection for primary colorectal cancer and SLM. SLM was defined as liver tumor detected before or during primary
Results
The intraoperative and postoperative outcomes are summarized in Table II.19, 20 The median operative duration was 553 minutes (range, 235–1,085 minutes) and the median intraoperative blood loss was 815 mL (range, 81–3,770 mL). There was no postoperative mortality. The incidence of postoperative complications (≥grade 1; Clavien–Dindo classification) was 61%. Major complications (≥grade 3) occurred in 23 (18%) patients.
There was 1 patient with grade A postoperative liver dysfunction according to
Discussion
The present study showed favorable outcomes and a high rate of simultaneous resection of 85% (127/150 patients), which was the greatest among the rates reported in recently published studies (range, 28%–55%; Table IV).6, 7, 8, 9, 10, 11, 12, 13, 22 The rate of major hepatectomy was also low at 14.2%, a characteristic finding of our study. Despite the high rate of simultaneous resection, there was no postoperative mortality, and the morbidity of 61% in the present study was comparable with that
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Cited by (31)
Simultaneous approach for patients with synchronous colon and rectal liver metastases: Impact of site of primary on postoperative and oncological outcomes
2021, European Journal of Surgical OncologyCitation Excerpt :In our series, simultaneous approach resulted to be feasible and safe with a 90-day mortality rate near 1% and a severe complication rate of almost 16% both in RC- and CC-group. RC surgery performed together with liver resection is regarded as a demanding procedure with an increased risk of anastomotic leak [25,28,29]. Unsurprisingly, patients in RC-Group showed a higher rate of anastomotic leak compared to CC-Group (6.4% vs. 1.6%; p = 0.033), but these results resemble those of patients undergoing colon and rectal resection in non-metastatic patients [30].
Simultaneous Versus Staged Resection of Colorectal Cancer Liver Metastasis: A Retrospective Single-Center Study
2020, Journal of Surgical ResearchPopulation level outcomes and costs of single stage colon and liver resection versus conventional two-stage approach for the resection of metastatic colorectal cancer
2019, HPBCitation Excerpt :Although a number of previous studies have sought to explore clinical outcomes after CR + LR, these studies have been limited as most were single-center case series.1–9 Additionally, these studies did not directly compare surgical approaches and were therefore unable fully to assess outcomes between the two operative approaches.3–6 Importantly, the current study adds to the literature in that we used a nationally representative dataset and calculated population-level estimates for clinical outcomes and costs among patients undergoing CR + LR.
Resection of the Primary Tumor in Stage IV Colorectal Cancer: When Is It Necessary?
2017, Surgical Clinics of North AmericaLong-term oncologic outcomes for simultaneous resection of synchronous metastatic liver and primary colorectal cancer
2016, Surgery (United States)Citation Excerpt :Nevertheless, some authors still recommended simultaneous resections only in patients requiring minor liver resections, because major liver resection is believed to be associated with increased morbidity and mortality rates.6,22 The most recently presented data have demonstrated the safety for simultaneous major liver and colorectal resections.11,23-26 Further studies will also have to evaluate the impact of laparoscopic procedures on outcome and management strategy in the future.