title: Comparison of minimally invasive and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases: a propensity score analysis.
abstract: OBJECTIVE
  The role of minimally invasive colorectal resection for patients undergoing a simultaneous resection for synchronous liver metastases had not been established. This study compared the short- and long-term outcomes between minimally invasive and open colorectal resection for patients undergoing simultaneous resection for liver metastases.
  
  
  METHODS
  This study reviewed 101 consecutive patients undergoing simultaneous colorectal resection and R0 resection of synchronous liver metastases between January 2008 and December 2012. In the study, 36 consecutive patients who underwent minimally invasive colorectal resection were matched with 36 patients who had an open approach by propensity scoring. The analyzed variables included patient and tumor characteristics and short-term and long-term outcomes.
  
  
  RESULTS
  After propensity score matching, the two groups had similar clinicopathologic variables. No patient undergoing the minimally invasive procedure experienced conversion to the open technique. No postoperative mortality occurred in either group. In the minimally invasive group, the estimated blood loss (P < 0.007), bowel function return time (P < 0.016), and postoperative hospital stay (P < 0.011) were significantly lower than those in the open group, although the operating time was significantly longer (P < 0.001). No significant differences in postoperative complications were observed between the groups. The two groups did not differ significantly in terms of the 5-year overall survival rate (51 vs. 55 %; P = 0.794) and disease-free survival rate (38 vs. 27 %; P = 0.860).
  
  
  CONCLUSIONS
  Minimally invasive colorectal resection with simultaneous resection of liver metastases has an outcome similar to open approach but some short-term advantages.
authors.affiliation: Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Lin
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Ye
authors.forename: Dexiang
authors.initials: D
authors.lastname: Zhu
authors.forename: Ye
authors.initials: Y
authors.lastname: Wei
authors.forename: Li
authors.initials: L
authors.lastname: Ren
authors.forename: Peng
authors.initials: P
authors.lastname: Zheng
authors.forename: Pingping
authors.initials: P
authors.lastname: Xu
authors.forename: Lechi
authors.initials: L
authors.lastname: Ye
authors.forename: Minzhi
authors.initials: M
authors.lastname: Lv
authors.forename: Jia
authors.initials: J
authors.lastname: Fan
authors.forename: Jianmin
authors.initials: J
authors.lastname: Xu
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003672:Defecation; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy / Q000009:adverse effects; D007902:Length of Stay; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D057216:Propensity Score; D020127:Recovery of Function; D012371:Robotics; D016896:Treatment Outcome