Laparoscopic resection of colorectal cancer facilitates simultaneous surgery of synchronous liver metastases
Article first published online: 20 DEC 2012
© 2012 The Authors Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland
Volume 15, Issue 1, pages e21–e28, January 2013
How to Cite
Hatwell, C., Bretagnol, F., Farges, O., Belghiti, J. and Panis, Y. (2013), Laparoscopic resection of colorectal cancer facilitates simultaneous surgery of synchronous liver metastases. Colorectal Disease, 15: e21–e28. doi: 10.1111/codi.12068
- Issue published online: 20 DEC 2012
- Article first published online: 20 DEC 2012
- Accepted manuscript online: 22 OCT 2012 11:05AM EST
- Manuscript Accepted: 22 JUN 2012
- Manuscript Received: 26 JAN 2012
- colorectal cancer;
- liver metastases
Combined resection of colorectal cancer with surgery for synchronous liver metastases (LM) still remains controversial because of the possible higher morbidity rate, the necessity of an adequate abdominal approach for both resections and the impact on oncological results. However, laparoscopy may be beneficial in terms of operative results and could facilitate this combined procedure. The aim was to assess the benefit of the laparoscopic approach for colorectal cancer resection in patients undergoing simultaneous liver resection for synchronous LM.
From 2006 to 2011, all patients with colorectal cancer and resectable synchronous LM, for which the total length of the procedure was suspected to be less than 8 h, underwent colorectal laparoscopic resection combined with open and/or laparoscopic liver surgery. In order to identify selection criteria, a comparative analysis was performed between patients with and without major postoperative morbidity.
Fifty-one patients underwent combined surgery with laparoscopic colectomy (n = 31) and proctectomy (n = 20). The conversion rate was 8%. Liver resections included major surgery (n = 10) and minor surgery (n = 41). Extraction of the colorectal specimen was performed through an incision used for open liver resection, except in seven patients who underwent a total laparoscopic procedure. Overall and major morbidity rates were 55% and 25%, respectively. Median (range) hospital stay was 16 (6–40) days. Regarding patient and tumour characteristics, no independent criteria of major morbidity risk were identified.
This study showed that laparoscopic colorectal resection combined with liver resection for synchronous LM was feasible and safe. Moreover, laparoscopy facilitates the surgical abdominal approach for combined colorectal and liver resection.