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Simultaneous robotic-assisted resection of colorectal cancer and synchronous liver metastases: a systematic review

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Abstract

Simultaneous resections of primary colorectal cancer (CRC) and synchronous colorectal liver metastases (CRLM) have emerged as safe and efficient procedures for selected patients. Besides the traditional open approach for simultaneous resections, similar outcomes have been reported for minimally invasive approaches. Over the past years, a number of studies have sought to evaluate the safety and efficacy of simultaneous robotic-assisted resections (SRAR) for patients with synchronous CRC and CRLM. The objective of this systematic review is to evaluate the safety, technical feasibility and outcomes of SRAR of the primary CRC and CRLM. A comprehensive review of the literature was undertaken. Nine studies comprising a total of 29 patients (16 males) who underwent SRAR were considered eligible for inclusion. The primary tumor site was the rectum in 22 (76%) patients and the colon in 7 (24%) patients. A minor liver resection was performed in the majority of the cases (n = 24; 82%). The median operative time and estimated blood loss were 399.5 min (range 300–682) and 274 ml (range 10–780 ml), respectively. No cases of conversion to open were reported. The median LOS was 7 days (range 2–28 days). All patients reportedly underwent R0 resection. Overall and major morbidity rates were 38% and 7%, respectively, while no perioperative deaths were reported. Despite the limited number of studies, SRAR seems to be a safe and efficient minimally invasive approach for highly selected patients always implemented in the context of multidisciplinary patient management.

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References

  1. Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70:7–30

    Article  Google Scholar 

  2. Manfredi S, Lepage C, Hatem C, Coatmeur O, Faivre J, Bouvier AM (2006) Epidemiology and management of liver metastases from colorectal cancer. Ann Surg 244:254–259

    Article  Google Scholar 

  3. Pawlik TM, Schulick RD, Choti MA (2008) Expanding criteria for resectability of colorectal liver metastases. Oncologist 13:51–64

    Article  Google Scholar 

  4. Ejaz A, Semenov E, Spolverato G, Kim Y, Tanner D, Hundt J, Pawlik TM (2014) Synchronous primary colorectal and liver metastasis: impact of operative approach on clinical outcomes and hospital charges. HPB 16:1117–1126

    Article  Google Scholar 

  5. Reddy SK, Pawlik TM, Zorzi D, Gleisner AL, Ribero D, Assumpcao L, Barbas AS, Abdalla EK, Choti MA, Vauthey JN, Ludwig KA, Mantyh CR, Morse MA, Clary BM (2007) Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol 14:3481–3491

    Article  Google Scholar 

  6. Boudjema K, Locher C, Sabbagh C, Ortega-Deballon P, Heyd B, Bachellier P, Metairie S, Paye F, Bourlier P, Adam R, Merdrignac A, Tual C, Le Pabic E, Sulpice L, Meunier B, Regimbeau JM, Bellissant E, Group MS (2020) Simultaneous versus delayed resection for initially resectable synchronous colorectal cancer liver metastases: a prospective, open-label, randomized, controlled trial. Ann Surg 273:49

    Article  Google Scholar 

  7. Moris D, Tsilimigras DI, Machairas N, Merath K, Cerullo M, Hasemaki N, Prodromidou A, Cloyd JM, Pawlik TM (2019) Laparoscopic synchronous resection of colorectal cancer and liver metastases: a systematic review. J Surg Oncol 119:30–39

    Article  Google Scholar 

  8. Duchalais E, Machairas N, Kelley SR, Landmann RG, Merchea A, Colibaseanu DT, Mathis KL, Dozois EJ, Larson DW (2018) Does obesity impact postoperative outcomes following robotic-assisted surgery for rectal cancer? Surg Endosc 32:4886

    Article  CAS  Google Scholar 

  9. Ioannidis A, Machairas N, Koutserimpas C, Spartalis E, Konstantinidis M, Konstantinidis K (2019) Evolution of robot-assisted general surgery in Greece and Cyprus. J Robot Surg 13:315–317

    Article  Google Scholar 

  10. Collins D, Machairas N, Duchalais E, Landmann RG, Merchea A, Colibaseanu DT, Kelley SR, Mathis KL, Dozois EJ, Larson DW (2017) Participation of colon and rectal fellows in robotic rectal cancer surgery: effect on surgical outcomes. J Surg Educ 75:465

    Article  Google Scholar 

  11. Duchalais E, Machairas N, Kelley SR, Landmann RG, Merchea A, Colibaseanu DT, Mathis KL, Dozois EJ, Larson DW (2018) Does prolonged operative time impact postoperative morbidity in patients undergoing robotic-assisted rectal resection for cancer? Surg Endosc 32:3659–3666

    Article  CAS  Google Scholar 

  12. Ioannidis A, Kontzoglou K, Kouraklis G, Machairas N, Chrysoheris P, Antonakopoulos F, Konstantinidis M, Filippou D, Skandalakis P, Konstantinidis K (2018) Short-term outcomes in patients with colon cancer treated with robotic right colectomy. J BUON 23:317–321

    PubMed  Google Scholar 

  13. Machairas N, Lang H, Jayant K, Raptis DA, Sotiropoulos GC (2020) Intrahepatic cholangiocarcinoma: limitations for resectability, current surgical concepts and future perspectives. Eur J Surg Oncol 46:740

    Article  Google Scholar 

  14. Machairas N, Papaconstantinou D, Tsilimigras DI, Moris D, Prodromidou A, Paspala A, Spartalis E, Kostakis ID (2019) Comparison between robotic and open liver resection: a systematic review and meta-analysis of short-term outcomes. Updates Surg 71:39–48

    Article  Google Scholar 

  15. Sotiropoulos GC, Prodromidou A, Kostakis ID, Machairas N (2017) Meta-analysis of laparoscopic vs open liver resection for hepatocellular carcinoma. Updates Surg 69:291–311

    Article  Google Scholar 

  16. Tsilimigras DI, Moris D, Vagios S, Merath K, Pawlik TM (2018) Safety and oncologic outcomes of robotic liver resections: a systematic review. J Surg Oncol 117:1517–1530

    Article  Google Scholar 

  17. Giovannetti A, Sucandy I, Dinallo A, Chudzinski AP, Ross SB, Massarotti HG, Rosemurgy AS (2019) Combined robotic colon and liver resection for synchronous colorectal liver metastasis: a movement toward a new gold standard. Am Surg 85:e374–e376

    Article  Google Scholar 

  18. Konstantinidis IT, Raoof M, Zheleva V, Lafaro K, Lau C, Fong Y, Lee B (2020) Multivisceral robotic liver surgery: feasible and safe. J Robot Surg 14:503–507

    Article  Google Scholar 

  19. Navarro J, Rho SY, Kang I, Choi GH, Min BS (2019) Robotic simultaneous resection for colorectal liver metastasis: feasibility for all types of liver resection. Langenbecks Arch Surg 404:895–908

    Article  Google Scholar 

  20. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 151:W65–W94

    Article  Google Scholar 

  21. Choi SB, Park JS, Kim JK, Hyung WJ, Kim KS, Yoon DS, Lee WJ, Kim BR (2008) Early experiences of robotic-assisted laparoscopic liver resection. Yonsei Med J 49:632–638

    Article  Google Scholar 

  22. Dwyer RH, Scheidt MJ, Marshall JS, Tsoraides SS (2018) Safety and efficacy of synchronous robotic surgery for colorectal cancer with liver metastases. J Robot Surg 12:603–606

    Article  Google Scholar 

  23. Eu EW, Ngu JC, Chiow AKH (2018) How to do a combined robotic anterior resection and liver resection: da Vinci Xi. ANZ J Surg 88:1076–1077

    Article  Google Scholar 

  24. Patriti A, Ceccarelli G, Bartoli A, Spaziani A, Lapalorcia LM, Casciola L (2009) Laparoscopic and robot-assisted one-stage resection of colorectal cancer with synchronous liver metastases: a pilot study. J Hepatobiliary Pancreat Surg 16:450–457

    Article  Google Scholar 

  25. Sunil S, Restrepo J, Azin A, Hirpara D, Cleary S, Cleghorn MC, Wei A, Quereshy FA (2017) Robotic simultaneous resection of rectal cancer and liver metastases. Clin Case Rep 5:1913–1918

    Article  Google Scholar 

  26. Xu JM, Wei Y, Wang XY, Fan H, Chang WJ, Ren L, Jiang W, Fan J, Qin XY (2015) Robot-assisted one-stage resection of rectal cancer with liver and lung metastases. World J Gastroenterol 21:2848–2853

    Article  Google Scholar 

  27. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien-Dindo classification of surgical complications: 5-year experience. Ann Surg 250:187–196

    Article  Google Scholar 

  28. Hajibandeh S, Hajibandeh S, Sultana A, Ferris G, Mwendwa J, Mohamedahmed AYY, Zaman S, Peravali R (2020) Simultaneous versus staged colorectal and hepatic resections for colorectal cancer with synchronous hepatic metastases: a meta-analysis of outcomes and clinical characteristics. Int J Colorectal Dis 35:1629–1650

    Article  Google Scholar 

  29. Fujita S, Akasu T, Moriya Y (2000) Resection of synchronous liver metastases from colorectal cancer. Jpn J Clin Oncol 30:7–11

    Article  CAS  Google Scholar 

  30. Mentha G, Majno PE, Andres A, Rubbia-Brandt L, Morel P, Roth AD (2006) Neoadjuvant chemotherapy and resection of advanced synchronous liver metastases before treatment of the colorectal primary. Br J Surg 93:872–878

    Article  CAS  Google Scholar 

  31. Gavriilidis P, Sutcliffe RP, Hodson J, Marudanayagam R, Isaac J, Azoulay D, Roberts KJ (2018) Simultaneous versus delayed hepatectomy for synchronous colorectal liver metastases: a systematic review and meta-analysis. HPB 20:11–19

    Article  Google Scholar 

  32. Shubert CR, Habermann EB, Bergquist JR, Thiels CA, Thomsen KM, Kremers WK, Kendrick ML, Cima RR, Nagorney DM (2015) A NSQIP review of major morbidity and mortality of synchronous liver resection for colorectal metastasis stratified by extent of liver resection and type of colorectal resection. J Gastrointest Surg 19:1982–1994

    Article  Google Scholar 

  33. Adam R, de Gramont A, Figueras J, Kokudo N, Kunstlinger F, Loyer E, Poston G, Rougier P, Rubbia-Brandt L, Sobrero A, Teh C, Tejpar S, Van Cutsem E, Vauthey JN, Pahlman L, the Eg (2015) Managing synchronous liver metastases from colorectal cancer: a multidisciplinary international consensus. Cancer Treat Rev 41:729–741

    Article  Google Scholar 

  34. Machairas N, Sotiropoulos GC (2019) Laparoscopic liver surgery: yesterday, today and tomorrow. Hepatobiliary Surg Nutr 8:324–326

    Article  Google Scholar 

  35. Ye SP, Qiu H, Liao SJ, Ai JH, Shi J (2019) Mini-invasive vs open resection of colorectal cancer and liver metastases: a meta-analysis. World J Gastroenterol 25:2819–2832

    Article  Google Scholar 

  36. Kamarajah SK, Bundred J, Manas D, Jiao LR, Hilal MA, White SA (2020) Robotic Versus conventional laparoscopic liver resections: a systematic review and meta-analysis. Scand J Surg. https://doi.org/10.1177/1457496920925637

  37. Chong CCN, Lok HT, Fung AKY, Fong AKW, Cheung YS, Wong J, Lee KF, Lai PBS (2020) Robotic versus laparoscopic hepatectomy: application of the difficulty scoring system. Surg Endosc 34:2000–2006

    Article  Google Scholar 

  38. Efanov M, Alikhanov R, Tsvirkun V, Kazakov I, Melekhina O, Kim P, Vankovich A, Grendal K, Berelavichus S, Khatkov I (2017) Comparative analysis of learning curve in complex robot-assisted and laparoscopic liver resection. HPB 19:818–824

    Article  Google Scholar 

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Correspondence to Nikolaos Machairas.

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Authors NM, PD, SK, PS, DS, GZ, AT and NN declare they have no conflicts of interest.

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Machairas, N., Dorovinis, P., Kykalos, S. et al. Simultaneous robotic-assisted resection of colorectal cancer and synchronous liver metastases: a systematic review. J Robotic Surg 15, 841–848 (2021). https://doi.org/10.1007/s11701-021-01213-8

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  • DOI: https://doi.org/10.1007/s11701-021-01213-8

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