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Outcomes of Simultaneous Major Liver Resection and Colorectal Surgery for Colorectal Liver Metastases

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The optimal surgical strategy for treating colorectal cancer liver metastases (CRLM) in patients requiring major liver resection (MLR) is controversial, especially in rectal cancer patients.

Method

Between March 2004 and January 2015, 103 patients underwent MLR for CRLM and underwent MLR simultaneously with colorectal surgery (simultaneous group; n = 55) or MLR after colorectal surgery (liver-only group; n = 48).

Results

There were no significant differences in sex, age, ASA score, BMI, size and number of liver metastases, liver resection margin, surgical outcomes, and estimated blood loss. The rates of postoperative complications (simultaneous group vs. liver-only group; 76.4 % vs. 62.5 %; P = 0.126) and major complications (29.0 % vs. 25.0 %; P = 0.513) were also similar in both groups. The time to starting a soft diet was longer in the simultaneous group (6.0 days vs. 3.4 days; P < 0.001), but the length of hospital stay was similar (14.9 days vs. 13.3 days; P = 0.345). There were no perioperative deaths, anastomotic leakage, or septic complications. Among patients who underwent rectal surgery, the frequency of complications was greater in the simultaneous group (87.0 % vs. 56.2 %; P = 0.031), but there was no difference in major complications (34.7 % vs. 25.0 %; P = 0.822). The postoperative morbidity index was 0.204 and 0.180 in the simultaneous and liver-only groups, respectively, in all patients, and was 0.227 and 0.136, respectively, in the rectal surgery subgroup.

Conclusion

Simultaneous MLR is feasible and safe in synchronous CRLM patients, including rectal cancer patients.

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Acknowledgments

This work was supported by a grant (no. 13-2015-024) from the Seoul National University Bundang Hospital Research Fund.

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Author notes

  1. Paramin Muangkaew

    Present address: Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Authors and Affiliations

  1. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Republic of Korea

    Paramin Muangkaew, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, YoungRok Choi, Jae Yool Jang, Hanlim Choi, Jae Seong Jang & Seong Uk Kwon

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  1. Paramin Muangkaew
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Muangkaew, P., Cho, J.Y., Han, HS. et al. Outcomes of Simultaneous Major Liver Resection and Colorectal Surgery for Colorectal Liver Metastases. J Gastrointest Surg 20, 554–563 (2016). https://doi.org/10.1007/s11605-015-2979-9

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  • DOI: https://doi.org/10.1007/s11605-015-2979-9

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