Hadrien Tranchart1,2, David Fuks3, Luca Vigano4,5, Stefano Ferretti1,2, François Paye6, Go Wakabayashi7, Alessandro Ferrero4, Brice Gayet3, Ibrahim Dagher8,9. 1. Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, Clamart, 92141, France. 2. Paris-Sud University, Orsay, 91405, France. 3. Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris, 75014, France. 4. Department of General and Oncological Surgery, Ospedale Mauriziano "Umberto I", Largo Turati 62, 10128, Turin, Italy. 5. Department of Hepatobiliary and General Surgery, Humanitas Research Hospital, IRCCS, Humanitas University, Via Manzoni 56, 20089, Rozzano, Milan, Italy. 6. Department of General Surgery, Saint Antoine Hospital, 75012, Paris, France. 7. Department of Surgery, Iwate Medical University School of Medicine, Morioka, 020-8505, Japan. 8. Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, Clamart, 92141, France. ibrahim.dagher@abc.aphp.fr. 9. Paris-Sud University, Orsay, 91405, France. ibrahim.dagher@abc.aphp.fr.
Abstract
BACKGROUND: Preliminary series have shown the feasibility of combined laparoscopic resection of colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM). The aim of this study was to compare the short- and long-term outcomes for matched patients undergoing combined resections. METHODS: An international multicenter database of 142 patients that underwent combined laparoscopic resection of CRC and SCRLM between 1997 and 2013 was compared to a database of 241 patients treated by open during the same period. Comparison of short- and long-term outcomes was performed after propensity score adjustment. RESULTS: After matching, 89 patients were compared in each group including mostly ASA I-II patients, presenting with mean number of 1.5 CRLM, with a mean diameter of 30 mm, and resectable by a wedge resection or a left lateral sectionectomy. A rectal resection was required in 46 and 43 % of laparoscopic and open procedures, respectively (p = 0.65). There was no difference in global operative time, blood loss and transfusion rates between the two groups. A conversion was required in 7 % of the laparoscopic procedures. Morbidity rates were similar in the two groups (p = 1.0). The 3-year overall survival in the laparoscopy and open groups were 78 and 65 %, respectively (p = 0.17). CONCLUSIONS: In patients without severe comorbidities presenting with one, small (≤3 cm), CRLM resectable by a wedge resection or a left lateral sectionectomy, combined laparoscopic resection of CRC and SCRLM allowed similar short- and long-term outcomes compared with the open approach.
BACKGROUND: Preliminary series have shown the feasibility of combined laparoscopic resection of colorectal cancer (CRC) and synchronous colorectal liver metastases (SCRLM). The aim of this study was to compare the short- and long-term outcomes for matched patients undergoing combined resections. METHODS: An international multicenter database of 142 patients that underwent combined laparoscopic resection of CRC and SCRLM between 1997 and 2013 was compared to a database of 241 patients treated by open during the same period. Comparison of short- and long-term outcomes was performed after propensity score adjustment. RESULTS: After matching, 89 patients were compared in each group including mostly ASA I-II patients, presenting with mean number of 1.5 CRLM, with a mean diameter of 30 mm, and resectable by a wedge resection or a left lateral sectionectomy. A rectal resection was required in 46 and 43 % of laparoscopic and open procedures, respectively (p = 0.65). There was no difference in global operative time, blood loss and transfusion rates between the two groups. A conversion was required in 7 % of the laparoscopic procedures. Morbidity rates were similar in the two groups (p = 1.0). The 3-year overall survival in the laparoscopy and open groups were 78 and 65 %, respectively (p = 0.17). CONCLUSIONS: In patients without severe comorbidities presenting with one, small (≤3 cm), CRLM resectable by a wedge resection or a left lateral sectionectomy, combined laparoscopic resection of CRC and SCRLM allowed similar short- and long-term outcomes compared with the open approach.
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
Authors: S Trastulli; R Cirocchi; C Listorti; D Cavaliere; N Avenia; N Gullà; G Giustozzi; F Sciannameo; G Noya; C Boselli Journal: Colorectal Dis Date: 2012-06 Impact factor: 3.788
Authors: Joseph F Buell; Daniel Cherqui; David A Geller; Nicholas O'Rourke; David Iannitti; Ibrahim Dagher; Alan J Koffron; Mark Thomas; Brice Gayet; Ho Seong Han; Go Wakabayashi; Giulio Belli; Hironori Kaneko; Chen-Guo Ker; Olivier Scatton; Alexis Laurent; Eddie K Abdalla; Prosanto Chaudhury; Erik Dutson; Clark Gamblin; Michael D'Angelica; David Nagorney; Giuliano Testa; Daniel Labow; Derrik Manas; Ronnie T Poon; Heidi Nelson; Robert Martin; Bryan Clary; Wright C Pinson; John Martinie; Jean-Nicolas Vauthey; Robert Goldstein; Sasan Roayaie; David Barlet; Joseph Espat; Michael Abecassis; Myrddin Rees; Yuman Fong; Kelly M McMasters; Christoph Broelsch; Ron Busuttil; Jacques Belghiti; Steven Strasberg; Ravi S Chari Journal: Ann Surg Date: 2009-11 Impact factor: 12.969
Authors: Marcello Giuseppe Spampinato; Lucio Mandalá; Giuseppe Quarta; Pietro Del Medico; Gianandrea Baldazzi Journal: Surgery Date: 2012-07-31 Impact factor: 3.982
Authors: Graziano Ceccarelli; Aldo Rocca; Michele De Rosa; Andrea Fontani; Fabio Ermili; Enrico Andolfi; Walter Bugiantella; Giovanni Battista Levi Sandri Journal: Updates Surg Date: 2021-04-08