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Simultaneous laparoscopic resection of primary colorectal cancer and associated liver metastases: a systematic review

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Abstract

As many as 25 % of colorectal cancer (CRC) patients have liver metastases at presentation. However, the optimal strategy for resectable synchronous colorectal liver metastasis remains controversial. Despite the increasing use of laparoscopy in colorectal and liver resections, combined laparoscopic resection of the primary CRC and synchronous liver metastasis is rarely performed. The potential benefits of this approach are the possibility to perform a radical operation with small incisions, earlier recovery, and reduction in costs. The aim of this study was to review the literature on feasibility and short-term results of simultaneous laparoscopic resection. We conducted a systematic search of all articles published until February 2013. Search terms included: hepatectomy [Mesh], “liver resection,” laparoscopy [Mesh], hand-assisted laparoscopy [Mesh], surgical procedures, minimally invasive [Mesh], colectomy [Mesh], colorectal neoplasms [Mesh], and “colorectal resections.” No randomized trials are available. All data have been reported as case reports, case series, or case–control studies. Thirty-nine minimally invasive simultaneous resections were identified in 14 different articles. There were 9 (23 %) major hepatic resections. The most performed liver resection was left lateral sectionectomy in 26 (67 %) patients. Colorectal resections included low rectal resections with total mesorectal excision, right and left hemicolectomies, and anterior resections. Despite the lack of high-quality evidence, the laparoscopic combined procedure appeared to be feasible and safe, even with major hepatectomies. Good patient selection and refined surgical technique are the keys to successful simultaneous resection. Simultaneous left lateral sectionectomy associated with colorectal resection should be routinely proposed.

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References

  1. Howlader N, Noone AM, Krapcho M et al SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, April 2012

  2. Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP (1991) Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 110:13–29

    CAS  PubMed  Google Scholar 

  3. Millikan KW, Staren ED, Doolas A (1997) Invasive therapy of metastatic colorectal cancer to the liver. Surg Clin North Am 77:27–28

    Article  CAS  PubMed  Google Scholar 

  4. Leonard GD, Brenner B, Kemeny NE (2005) Neoadjuvant chemotherapy before liver resection for patients with unresectable liver metastases from colorectal carcinoma. J Clin Oncol 23:2038–2048

    Article  CAS  PubMed  Google Scholar 

  5. Abdalla EK, Vauthey JN, Ellis LM et al (2004) Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg 239:818–825

    Article  PubMed  Google Scholar 

  6. Choti MA, Sitzmann JV, Tiburi MF et al (2002) Trends in long-term survival following liver resection for hepatic colorectal metastases. Ann Surg 235:759–766

    Article  PubMed  Google Scholar 

  7. Abdalla EK, Adam R, Bilchik AJ, Jaeck D, Vauthey JN, Mahvi D (2006) Improving resectability of hepatic colorectal metastases: expert consensus statement. Ann Surg Oncol 13:1271–1280

    Article  PubMed  Google Scholar 

  8. Bolton JS, Fuhrman GM (2000) Survival after resection of multiple bilobar hepatic metastases from colorectal carcinoma. Ann Surg 231:743–751

    Article  CAS  PubMed  Google Scholar 

  9. Reddy SK, Pawlik TM, Zorzi D et al (2007) Simultaneous resections of colorectal cancer and synchronous liver metastases: a multi-institutional analysis. Ann Surg Oncol 14:3481–3491

    Article  PubMed  Google Scholar 

  10. Capussotti L, Ferrero A, Viganò L, Ribero D, Lo Tesoriere R, Polastri R (2007) Major liver resections synchronous with colorectal surgery. Ann Surg Oncol 14:195–201

    Article  PubMed  Google Scholar 

  11. Nguyen KT, Laurent A, Dagher I et al (2009) Minimally invasive liver resection for metastatic colorectal cancer: a multi-institutional, international report of safety, feasibility, and early outcomes. Ann Surg 250:842–848

    Article  PubMed  Google Scholar 

  12. Lee JS, Hong HT, Kim JH et al (2010) Simultaneous laparoscopic resection of primary colorectal cancer and metastatic liver tumor: initial experience of single institute. J Laparoendosc Adv Surg Tech 20:683–687

    Article  Google Scholar 

  13. Mahid SS, Hornung CA, Minor KS, Turina M, Galandiuk S (2006) Systematic reviews and meta-analysis for the surgeon scientist. Br J Surg 93:1315–1324

    Article  CAS  PubMed  Google Scholar 

  14. Chen KY, **ang GA, Wang HN, **ao FI (2011) Simultaneous laparoscopic excision for rectal carcinoma and synchronous hepatic metastasis. Chin Med J 124:2990–2992

    PubMed  Google Scholar 

  15. Geiger TM, Tebb ZD, Sato E, Miedema BW, Awad ZT (2006) Laparoscopic resection of colon câncer and synchronous liver metastases. J Laparoendosc Adv Surg Tech 16:51–53

    Article  Google Scholar 

  16. Leung KL, Lee JF, Yiu RY, Ng SS, Li JC (2006) Simultaneous laparoscopic resection of rectal cancer and liver metastasis. J Laparoendosc Adv Surg Tech 16:486–488

    Article  Google Scholar 

  17. Casaccia M, Famiglietti F, Andorno E, Di Domenico S, Ferrari C, Valente U (2010) Simultaneous laparoscopic anterior resection and left hepatic lobectomy for stage IV rectal cancer. JSLS 14:414–417

    Article  PubMed Central  PubMed  Google Scholar 

  18. Lupinacci RM, Machado MA, Lupinacci RA, Herman P (2011) Simultaneous left colectomy and standard hepatectomy performed by laparoscopy. Rev Col Bras Cir 38:139–141

    Article  PubMed  Google Scholar 

  19. Bretagnol F, Hatwell C, Farges O, Alves A, Belghiti J, Panis Y (2008) Benefit of laparoscopy for rectal resection in patients operated simultaneously for synchronous liver metastases: a preliminary experience. Surgery 144:436–441

    Article  PubMed  Google Scholar 

  20. Kim SH, Lim SB, Ha YH et al (2008) Laparoscopic-assisted combined colon and liver resection for primary colorectal cancer with synchronous liver metastases: initial experience. World J Surg 32:2701–2706

    Article  PubMed  Google Scholar 

  21. Patriti A, Ceccarelli G, Bartoli A, Spaziani A, Lapalorcia LM, Casciola L (2009) Laparoscopic and robot-assisted one-stage resection of colorectal cancer with synchronous liver metastases: a pilot study. J Hepatobiliary Pancreat Surg 16:450–457

    Article  PubMed  Google Scholar 

  22. Lee JS, Hong HT, Kim JH et al (2010) Simultaneous laparoscopic resection of primary colorectal cancer and metastatic liver tumor: initial experience of single institute. J Laparoendosc Adv Surg Tech A 20:683–687

    Article  PubMed  Google Scholar 

  23. Tranchart H, Diop PS, Lainas P et al (2011) Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis. HPB (Oxford) 13:46–50

    Article  Google Scholar 

  24. Sasaki A, Nitta H, Otsuka K, Takahara T, Nishizuka S, Wakabayashi G (2009) Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg 96:274–279

    Article  CAS  PubMed  Google Scholar 

  25. Huh JW, Koh YS, Kim HR, Cho CK, Kim YJ (2011) Comparison of laparoscopic and open colorectal resection for patients undergoing simultaneous R0 resection for liver metastases. Surg Endosc 25:193–198

    Article  PubMed  Google Scholar 

  26. Biondi A, Grosso G, Mistretta A et al (2013) Laparoscopic-assisted versus open surgery for colorectal cancer: short-and long-term outcomes comparison. J Laparoendosc Adv Surg Tech A 23:1–7

    Article  PubMed  Google Scholar 

  27. Jensen CC, Prasad LM, Abcarian H (2012) Cost-effectiveness of laparoscopic vs. open resection for colon and rectal cancer. Dis Colon Rectum 55:1017–1023

    Article  PubMed  Google Scholar 

  28. **ong B, Ma L, Zhang C (2012) Laparoscopic versus open total mesorectal excision for middle and low rectal cancer: a meta-analysis of results of randomized controlled trials. J Laparoendosc Adv Surg Tech A 22:674–684

    Article  PubMed  Google Scholar 

  29. Hatwell C, Bretagnol F, Farges O, Belghiti J, Panis Y (2013) Laparoscopic resection of colorectal cancer facilitates simultaneous surgery of synchronous liver metastases. Colorectal Dis 15:e21–e28

    Article  CAS  PubMed  Google Scholar 

  30. Rao A, Rao G, Ahmed I (2012) Laparoscopic vs. open liver resection for malignant liver disease. A systematic review. Surgeon 10:194–201

    Article  PubMed  Google Scholar 

  31. Chen J, Li Q, Wang C, Zhu H, Shi Y, Zhao G (2011) Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis. Int J Colorectal Dis 26:191–199

    Article  PubMed  Google Scholar 

  32. Tanaka K, Shimada H, Matsuo K et al (2004) Outcome after simultaneous colorectal and hepatic resection for colorectal cancer with synchronous metastases. Surgery 136:650–659

    Article  PubMed  Google Scholar 

  33. Elias D, Detroz B, Lasser P, Plaud B, Jerbi G (1995) Is simultaneous hepatectomy and intestinal anastomosis safe? Am J Surg 169:254–260

    Article  CAS  PubMed  Google Scholar 

  34. Mentha G, Majno P, Terraz S et al (2007) Treatment strategies for the management of advanced colorectal liver metastases detected synchronously with the primary tumor. Eur J Surg Oncol 33(Suppl 2):S76–S83

    Article  PubMed  Google Scholar 

  35. Rubbia-Brandt L, Audard V, Sartoretti P et al (2004) Severe hepatic sinusoidal obstruction associated with oxaliplatin-based chemotherapy in patients with metastatic colorectal cancer. Ann Oncol 15:460–466

    Article  CAS  PubMed  Google Scholar 

  36. Vauthey JN, Pawlik TM, Ribero D et al (2006) Chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. J Clin Oncol 24:2065–2072

    Article  CAS  PubMed  Google Scholar 

  37. Pathak S, Sarno G, Nunes QM, Poston GJ (2010) Synchronous resection for colorectal liver metastases: the future. Eur J Surg Oncol 36:1044–1046

    Article  CAS  PubMed  Google Scholar 

  38. Bryant R, Laurent A, Tayar C, Cherqui D (2009) Laparoscopic liver resection-understanding its role in current practice: the Henri Mondor Hospital experience. Ann Surg 250:103–111

    Article  PubMed  Google Scholar 

  39. Troisi RI, Van Huysse J, Berrevoet F et al (2011) Evolution of laparoscopic left lateral sectionectomy without the Pringle maneuver: through resection of benign and malignant tumors to living liver donation. Surg Endosc 25:79–87

    Article  PubMed Central  PubMed  Google Scholar 

  40. Lee KF, Wong J, Cheung YS, Ip P, Wong J, Lai PB (2010) Resection margin in laparoscopic hepatectomy: a comparative study between wedge resection and anatomic left lateral sectionectomy. HPB (Oxford) 12:649–653

    Article  Google Scholar 

  41. Spampinato MG, Mandalá L, Quarta G, Del Medico P, Baldazzi G (2013) One-stage, totally laparoscopic major hepatectomy and colectomy for colorectal neoplasm with synchronous liver metastasis: safety, feasibility and short-term outcome. Surgery 153:861–865

    Article  PubMed  Google Scholar 

  42. Polignano FM, Quyn AJ, Sanjay P, Henderson NA, Tait IS (2012) Totally laparoscopic strategies for the management of colorectal cancer with synchronous liver metastasis. Surg Endosc 26:2571–2578

    Article  PubMed  Google Scholar 

  43. Hu MG, Ou-yang CG, Zhao GD, Xu DB, Liu R (2012) Outcomes of open versus laparoscopic procedure for synchronous radical resection of liver metastatic colorectal cancer: a comparative study. Surg Laparosc Endosc Percutan Tech 22:364–369

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank Mrs. Marta for her support during the literature review.

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Authors and Affiliations

  1. Department of Gastroenterology, University of São Paulo Medical School, São Paulo, Brazil

    R. M. Lupinacci, W. Andraus, L. B. De Paiva Haddad, L. A. Carneiro D′Albuquerque & P. Herman

  2. Av. Dr Enéas de Carvalho Aguiar, 155, São Paulo, 05403-000, Brazil

    R. M. Lupinacci

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  1. R. M. Lupinacci
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  2. W. Andraus
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Correspondence to R. M. Lupinacci.

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Lupinacci, R.M., Andraus, W., De Paiva Haddad, L.B. et al. Simultaneous laparoscopic resection of primary colorectal cancer and associated liver metastases: a systematic review. Tech Coloproctol 18, 129–135 (2014). https://doi.org/10.1007/s10151-013-1072-1

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