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Major Liver Resections Synchronous with Colorectal Surgery

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Abstract

Background

Surgical strategy in liver metastases synchronous to colorectal cancer remains controversial. The aim of this study was to evaluate feasibility and short-term outcomes of major hepatectomies synchronous to colorectal surgery.

Methods

Between January 1985 and December 2004, 79 patients underwent major hepatectomy for metastases synchronous to colorectal cancer; 31 underwent synchronous hepatectomy and colorectal surgery, and 48 underwent delayed liver resection.

Results

The synchronous group had a higher rate of right colectomy (38.7% vs. 18.8%, P = .0499) and larger metastases (8 vs. 5.3 cm, P = .0032). Mortality (one patient in synchronous group), morbidity, and anastomotic leak rates were similar in the two groups. Colon-related morbidity did not cause adjunctive liver complications. Hospitalization in delayed hepatectomies was shorter (10.4 days vs. 13.9 days, P = .0021). Blood and plasma transfusions were higher in synchronous resections (41.9% vs. 16.7%, P = .0131 and 54.8% vs. 31.3%, P = .0370); no differences were found in the last 10 years. Considering both surgical procedures (colorectal + liver resection), in delayed hepatectomies, morbidity was higher (56.3% vs. 32.6%, P = .0369) and hospitalization was longer (20.5 vs. 13.9 days, P = .00001). Nine patients underwent major hepatectomy at the same time as anterior rectal resection with no mortality (morbidity 22.2%, mean hospitalization 12.4 days).

Conclusions

Major hepatectomies can be safely performed at the same time as colorectal surgery in selected patients with synchronous metastases with similar short-term results, even in the presence of rectal cancer.

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Authors and Affiliations

  1. Unit of Surgical Oncology, Institute for Cancer Research and Treatment, Strada Provinciale 142 km 3, 95 10060, Candiolo, Torino, Italy

    Lorenzo Capussotti MD, Alessandro Ferrero MD, Luca Viganò MD, Dario Ribero MD, Roberto Lo Tesoriere MD & Roberto Polastri MD

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  1. Lorenzo Capussotti MD
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  2. Alessandro Ferrero MD
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  3. Luca Viganò MD
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  4. Dario Ribero MD
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  5. Roberto Lo Tesoriere MD
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  6. Roberto Polastri MD
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Correspondence to Lorenzo Capussotti MD.

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Capussotti, L., Ferrero, A., Viganò, L. et al. Major Liver Resections Synchronous with Colorectal Surgery. Ann Surg Oncol 14, 195–201 (2007). https://doi.org/10.1245/s10434-006-9055-3

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  • DOI: https://doi.org/10.1245/s10434-006-9055-3

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