Laparoscopic Resection of Primary Tumor with Synchronous Conventional Resection of Liver Metastases in Patients with Stage 4 Colorectal Cancer: A Retrospective Analysis

• Published in: Turkish journal of colorectal disease Vol. 29; no. 1; pp. 46 - 51
• Main Authors: Okkabaz, Nuri, Haksal, Mustafa C., Öncel, Mustafa
• Format: Journal Article
• Language: English
• Published: Mersin Türk Kolon Ve Rektum Cerrahisi Derneği 01.03.2019; Galenos Publishing House
• Subjects: Colorectal cancer; Colorectal surgery; Laparoscopy; Liver; liver metastasis; Metastasis; Patients; synchronous tumor; Tıp; Tumors; İstanbul; liver metastasis; colorectal cancer; karaciğer metastaz; kolorektal kanser; senkron tümör; Laparoscopy; synchronous tumor; Laparoskopi
• ISSN: 2536-4898; 2536-4901
• DOI: 10.4274/tjcd.galenos.2018.62534

Aim: Aim of this study is to analyze the short and long term results of laparoscopic colorectal cancer resection with synchronous conventional resection of liver metastasis. Method: All cases operated on synchronous colorectal cancer and liver metastasis between 2009 and 2017 were retrospectively retrieved from a prospective database. Three and more liver segment resection was considered as major resection. Demographics, patient characteristics, operative and postoperative findings and survival were analyzed. Results: A total of 35 patients [23 (65.7%) male, median age: 56 (34-79)] was included to the study. The most common primary tumor localization was rectum (n=20, 57.1%). Neoadjuvant chemoradiotherapy and chemotherapy was applied in 15 (75%) and 14 (40%) cases, respectively. Major, minor resection or only ablative therapy performance was 12 (34.3%), 19 (54.3%) and 4 (11.4%), respectively, but 13 (37.1%) cases received both resection and ablative therapy. Mean operation time was 307.8±103.6 minutes and estimated blood loss was 300 (10-2200) cc. Blood transfusion was needed in 15 (42.9%) cases. Length of stay was 7 (4-17) days. Eleven complications developed in 10 (28.6%) cases, but none required re-operation. A patient (2.9%) underwent laparoscopic low anterior resection with major hepatectomy and radiofrequency ablation was deceased in postoperative 11th day due to liver failure and subsequent multiorgan failure. Three, 5, 7 and 9-year survival rates was 63%, 35%, 35%, and 35%. Conclusion: Laparoscopic colorectal resection with synchronous conventional liver resection in patients with metastatic colorectal cancer is safe and feasible. Long term survival rates are acceptable.