Simultaneous laparoscopic colorectal and hepatic resection for patients with colorectal cancer and synchronous liver metastases: a multicenter series

Abstract

Background: Laparoscopic resection is considered a viable treatment option for both colorectal cancer and colorectal liver metastases. The aim of this study was to present the results of a multicenter experience with totally laparoscopic simultaneous colorectal and liver resection. Methods: All patients with colorectal liver metastases that underwent simultaneous resection of colorectal primary and liver metastases were selected from a retrospective database containing all laparoscopic liver resections performed in the associated centers. Patient characteristics and perioperative outcomes were reported. Results: Sixty-three patients met the inclusion criteria. The primary tumor was most commonly located in the sigmoid (n=27, 42%). Liver metastases were mostly solitary (n=43, 67%). In most cases (n=54, 86%) a single stage minor liver resection sufficed. A conversion was necessary in 3 patients (5%). Hand-assistance was used in 6 (9%) and robot-assisted surgery was used in 2 (3%) cases. Median operative time was 206 minutes (IQR 170-310) and median blood loss was 200 ml (IQR 100-700). Major postoperative morbidity was 18% (n=11), including anastomic dehiscence 6% (n=4) and 30 day mortality 0%. Conclusion: Simultaneous laparoscopic colorectal and hepatic resection seems an appropriate treatment strategy in selected patients with colorectal cancer and synchronous liver metastases. The current results apply to patients with solitary or multiple small liver metastasis that require a minor liver resection only.