BACKGROUND: Simultaneous colorectal and hepatic surgery for colorectal cancer (CRC) is increasing as surgery becomes safer and less invasive. There is controversy regarding the morbidity associated with simultaneous, compared with separate or staged, resections. METHODS: Data for 2005-2008 from the National Surgical Quality Improvement Program (NSQIP) were used to compare morbidity after 19,925 colorectal procedures for CRC (CR group), 2295 hepatic resections for metastatic CRC (HEP group), and 314 simultaneous colorectal and hepatic resections (SIM group). RESULTS: An increasing number of simultaneous resections were performed per year. Fewer major colorectal and liver resections were performed in the SIM than in the CR and HEP groups. Patients in the SIM group had a longer operative time and postoperative length of stay compared with those in either the CR or HEP groups. Simultaneous procedures resulted in higher rates of postoperative morbidity and major morbidity than CR procedures, but not HEP procedures. This difference was driven by higher rates of wound and organ space infections, and a greater incidence of septic shock. Mortality rates did not differ among the groups. CONCLUSIONS: Hospitals in the NSQIP are performing more simultaneous colonic and hepatic resections for CRC. These procedures are associated with increases in operative time, length of stay and rate of perioperative complications. Simultaneous procedures do not, however, increase perioperative mortality.
BACKGROUND: Simultaneous colorectal and hepatic surgery for colorectal cancer (CRC) is increasing as surgery becomes safer and less invasive. There is controversy regarding the morbidity associated with simultaneous, compared with separate or staged, resections. METHODS: Data for 2005-2008 from the National Surgical Quality Improvement Program (NSQIP) were used to compare morbidity after 19,925 colorectal procedures for CRC (CR group), 2295 hepatic resections for metastatic CRC (HEP group), and 314 simultaneous colorectal and hepatic resections (SIM group). RESULTS: An increasing number of simultaneous resections were performed per year. Fewer major colorectal and liver resections were performed in the SIM than in the CR and HEP groups. Patients in the SIM group had a longer operative time and postoperative length of stay compared with those in either the CR or HEP groups. Simultaneous procedures resulted in higher rates of postoperative morbidity and major morbidity than CR procedures, but not HEP procedures. This difference was driven by higher rates of wound and organ space infections, and a greater incidence of septic shock. Mortality rates did not differ among the groups. CONCLUSIONS: Hospitals in the NSQIP are performing more simultaneous colonic and hepatic resections for CRC. These procedures are associated with increases in operative time, length of stay and rate of perioperative complications. Simultaneous procedures do not, however, increase perioperative mortality.
Authors: Eddie K Abdalla; René Adam; Anton J Bilchik; Daniel Jaeck; Jean-Nicolas Vauthey; David Mahvi Journal: Ann Surg Oncol Date: 2006-09-06 Impact factor: 5.344
Authors: Srinevas K Reddy; Timothy M Pawlik; Daria Zorzi; Ana L Gleisner; Dario Ribero; Lia Assumpcao; Andrew S Barbas; Eddie K Abdalla; Michael A Choti; Jean-Nicolas Vauthey; Kirk A Ludwig; Christopher R Mantyh; Michael A Morse; Bryan M Clary Journal: Ann Surg Oncol Date: 2007-09-01 Impact factor: 5.344
Authors: Maximilian Bockhorn; Andreja Frilling; Nils R Frühauf; Jan Neuhaus; Ernesto Molmenti; Tanja Trarbach; Massimo Malagó; Hauke Lang; Christoph E Broelsch Journal: J Gastrointest Surg Date: 2008-06-03 Impact factor: 3.452
Authors: Shukri F Khuri; William G Henderson; Jennifer Daley; Olga Jonasson; R Scott Jones; Darrell A Campbell; Aaron S Fink; Robert M Mentzer; Leigh Neumayer; Karl Hammermeister; Cecilia Mosca; Nancy Healey Journal: Ann Surg Date: 2008-08 Impact factor: 12.969
Authors: Neil H Bhayani; Jennifer L Miller; Gail Ortenzi; Jussuf T Kaifi; Eric T Kimchi; Kevin F Staveley-O'Carroll; Niraj J Gusani Journal: J Gastrointest Surg Date: 2013-10-29 Impact factor: 3.452