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

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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.

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Acknowledgment

The authors want to thank Dr Satoshi Ogiso, Dr Marco Colasanti, Dr Stefano Berti, and Dr Martin Gaillard for their assistance in the acquisition of data. All the authors agree with the submission.

Conflicts of interest

All authors have no conflicts of interest or financial ties to disclose.

Disclosure

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Author notes

    Authors and Affiliations

    1. Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, Paris-Sud University, 157 rue de la Porte de Trivaux, 92141, Clamart, France

      Stefano Ferretti, Hadrien Tranchart & Ibrahim Dagher

    2. Department of Surgery, Tulane Abdominal Transplant Institute, New Orleans, 70112, USA

      Joseph F. Buell

    3. Division of General Surgery, Sant’Andrea Hospital, 19100, La Spezia, Italy

      Constantino Eretta

    4. Division of General Minimally Invasive and Robotic Surgery, San Matteo degli Infermi Hospital, 06049, Perugia, Italy

      Alberto Patriti

    5. HPB and Advanced Laparoscopic Surgical Unit, Policlinico of Abano Terme, 35031, Abano Terme, Italy

      Marcello Giuseppe Spampinato

    6. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Seoul, 135-710, South Korea

      Jung Wook Huh

    7. Department of HPB and Digestive Surgery, Ospedale Mauriziano Umberto I, 10100, Turin, Italy

      Luca Vigano

    8. Department of Surgery, Seoul National University Bundang Hospital, Seoul, 135-710, South Korea

      Ho Seong Han

    9. General Surgery and Liver Transplantation Unit, San Camillo Forlanini Hospital, 00152, Rome, Italy

      Giuseppe Maria Ettorre

    10. Department of Surgery, Maggiore Hospital, 40133, Bologna, Italy

      Elio Jovine

    11. Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, 53226, USA

      Thomas Clark Gamblin

    12. Division of General Surgery, S. Maria di Loreto Nuevo Hospital, 80142, Naples, Italy

      Giulio Belli

    13. Department of Surgery, Iwate Medical University School of Medicine, Morioka, 020-8505, Japan

      Go Wakabayashi

    14. Department of Digestive Diseases, Institut Mutualiste Montsouris, 75014, Paris, France

      Brice Gayet

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    1. Stefano Ferretti
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    2. Hadrien Tranchart
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    8. Luca Vigano
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    Corresponding author

    Correspondence to Hadrien Tranchart.

    Additional information

    Stefano Ferretti and Hadrien Tranchart have contributed equally to this work.

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    Ferretti, S., Tranchart, H., Buell, J.F. et al. Laparoscopic Simultaneous Resection of Colorectal Primary Tumor and Liver Metastases: Results of a Multicenter International Study. World J Surg 39, 2052–2060 (2015). https://doi.org/10.1007/s00268-015-3034-4

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