One-stage pure laparoscopic resection of primary colorectal cancer and synchronous hepatic metastases: a single institution experience

Abstract

Background: Simultaneous pure laparoscopic resection (SPLR) of the primary colorectal cancer and synchronous liver metastases (LM) is rarely performed. The aim of this study is to review a single institution experience. Methods: Between 2012 and 2016, 64 patients underwent laparoscopic liver resection for various benign and malignant liver tumors. The analysis included SPLR. The primary outcomes of this study were clinical and pathological variables. The secondary outcome was survival. Results: Eight patients underwent SPLR with laparoscopic colectomy (n = 3) and proctectomy (n = 5). Liver resections included only minor surgery: left lateral sectionectomies (n = 4) and atypical resections (n = 4). Average operating time was 270 minutes (range 180 - 390 minutes). Estimated blood loss was in average 380 mL (range 50-600 mL). Conversion to open procedure was performed in one patient. All patients had only one LM and the size was in average 2.6 cm (range 1 – 5 cm). R0 resection was achieved in all cases. Resection margin was in average 6.8 mm (range 2-15 mm). Median (range) hospital stay was 9 (7-42) days. The number of major morbidity was: 1 (Clavien-Dindo 3B), and there was no postoperative mortality. Median follow-up for surviving patients was 13 months. Six patients are alive with no evidence of disease, one patient is alive with disease and one patient died of disease. Conclusion: SPLR is feasible and safe for treatment of synchronous LM and there is no compromise of oncological surgical principles.