title: Predictive factors for anastomotic leakage after simultaneous resection of synchronous colorectal liver metastasis.
abstract: BACKGROUND
  The optimal surgical strategy for resectable, synchronous, colorectal liver metastases remains unclear. The objective of this study was to determine which patients could benefit from staged resections instead of simultaneous resection by identifying predictive factors for postoperative morbidity and anastomotic leakage after simultaneous resection of synchronous, colorectal liver metastases and the primary colorectal tumor.
  
  
  METHODS
  This study involved 86 patients with synchronous colorectal liver metastases who underwent simultaneous resection of the primary colorectal tumor and the hepatic tumor. Postoperative mortality, morbidity, and other surgical outcomes, including survival and hospitalization, were assessed. Predictive factors for postoperative morbidity and for anastomotic leakage were evaluated.
  
  
  RESULTS
  Postoperative morbidity and anastomotic leakage were found in 55 (64%) and 18 (21%) patients. Predictive factors for postoperative morbidity and for anastomotic leakage were intraoperative blood loss and operation time >8 h, respectively. The overall 5-year survival rate was 45%.
  
  
  CONCLUSIONS
  The frequency of morbidity and that of anastomotic leakage seemed to be high after simultaneous resection for synchronous colorectal liver metastases, especially when intraoperative blood loss or operation time increased greatly. Staged resections should be considered in cases in which excessive surgical stress from simultaneous resection of synchronous colorectal liver metastases would be expected.
authors: Department of Colorectal Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors: Kentaro
authors: K
authors: Nakajima
authors: Shinichiro
authors: S
authors: Takahashi
authors: Norio
authors: N
authors: Saito
authors: Masahito
authors: M
authors: Kotaka
authors: Masaru
authors: M
authors: Konishi
authors: Naoto
authors: N
authors: Gotohda
authors: Yuichiro
authors: Y
authors: Kato
authors: Taira
authors: T
authors: Kinoshita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D057868:Anastomotic Leak / Q000209:etiology*; D016063:Blood Loss, Surgical; D001810:Blood Volume; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects; D003106:Colon / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D007082:Ileum / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors