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Benefits of simultaneous laparoscopic resection of primary colorectal cancer and liver metastases
Author(s) -
Takasu Chie,
Shimada Mitsuo,
Sato Hirohiko,
Miyatani Tomohiko,
Imura Satoru,
Morine Yuji,
Ikemoto Tetsuya,
Kanamoto Mami,
Kurita Nobuhiro,
Eto Shohei,
Utsunomiya Tohru
Publication year - 2014
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/ases.12066
Subject(s) - medicine , colorectal cancer , blood loss , resection , surgery , incidence (geometry) , laparoscopy , primary tumor , laparoscopic surgery , cancer , metastasis , physics , optics
Recently, consensus on the optimal strategy for resectable synchronous colorectal liver metastases ( LM ) seems to have shifted toward simultaneous resection. However, there are still relatively few reports about simultaneous laparoscopic resection. The aim of this study is to evaluate the outcomes of patients who underwent simultaneous laparoscopic resection. Methods We evaluated 14 patients who underwent simultaneous resection of primary colorectal cancer and LM in our hospital from 2004 to 2012. Patients were selected by matched pair analysis based on the number of LM (≤4) and tumor size (≤5 cm). We divided them into two groups: the simultaneous laparoscopic resection of primary colorectal cancer and LM ( L ap‐ S ) group ( n = 7) and the simultaneous open resection of primary colorectal cancer and LM ( O pen‐ S ) group ( n = 7). Clinical and oncologic outcomes were compared between the groups. Results The L ap‐ S patients were significantly older than the O pen‐ S patients. The mean operative times of L ap‐ S and O pen‐ S were 472 min and 466 min, respectively. The mean blood loss was significantly smaller in the L ap‐ S group (153 mL) than in the O pen‐ S group (496 mL). There was no surgical mortality in either group. The incidence of postoperative complications in the L ap‐ S and O pen‐ S groups was 12.3% and 33.0%, respectively. The mean postoperative hospital stay was significantly shorter in the L ap‐ S group (16 days) than in the O pen‐ S group (36 days). There was no significant difference in long‐term survival between the two groups. Conclusion L ap‐ S patients had equivalent long‐term outcomes to O pen‐ S patients. Therefore, given its technical feasibility and safety, L ap‐ S may be one of the most promising options in selected patients.