Laparoscopic simultaneous resection of colorectal primary tumor and liver metastases: a propensity score matching analysis

Hadrien Tranchart, David Fuks, Luca Vigano, Stefano Ferretti, François Paye, Go Wakabayashi, Alessandro Ferrero, Brice Gayet, Ibrahim Dagher

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalSurgical Endoscopy and Other Interventional Techniques
DOIs
Publication statusAccepted/In press - Aug 15 2015

Keywords

  • Colorectal resection
  • Colorectal tumor
  • Laparoscopy
  • Liver metastases
  • Liver resection

ASJC Scopus subject areas

  • Surgery

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