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



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.



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).



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.
Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, Clamart, 92141, France.|Paris-Sud University, Orsay, 91405, France.
Hadrien
H
Tranchart
Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris, 75014, France.
David
D
Fuks
Department of General and Oncological Surgery, Ospedale Mauriziano "Umberto I", Largo Turati 62, 10128, Turin, Italy.|Department of Hepatobiliary and General Surgery, Humanitas Research Hospital, IRCCS, Humanitas University, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Luca
L
Vigano
Department of Minimally Invasive Digestive Surgery, Antoine Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, Clamart, 92141, France.|Paris-Sud University, Orsay, 91405, France.
Stefano
S
Ferretti
Department of General Surgery, Saint Antoine Hospital, 75012, Paris, France.
François
F
Paye
Department of Surgery, Iwate Medical University School of Medicine, Morioka, 020-8505, Japan.
Go
G
Wakabayashi
Department of General and Oncological Surgery, Ospedale Mauriziano "Umberto I", Largo Turati 62, 10128, Turin, Italy.
Alessandro
A
Ferrero
Department of Digestive Diseases, Institut Mutualiste Montsouris, Paris, 75014, France.
Brice
B
Gayet
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.|Paris-Sud University, Orsay, 91405, France. ibrahim.dagher@abc.aphp.fr.
Ibrahim
I
Dagher
D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D015179:Colorectal Neoplasms / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D061646:Operative Time; D057216:Propensity Score; D016019:Survival Analysis
Colorectal resection; Colorectal tumor; Laparoscopy; Liver metastases; Liver resection