Comparison of laparoscopic and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases

The role of laparoscopic colorectal resection for patients undergoing a simultaneous operation for liver metastases had not been established. This study compared the outcomes between laparoscopic and open colorectal resections for patients undergoing simultaneous surgery for liver metastases.

This study reviewed 40 consecutive patients undergoing simultaneous R0 resection of synchronous liver metastases between January 2003 and August 2008. In the study, 20 patients who underwent laparoscopic colorectal resection were matched with 20 patients who had an open approach. All available clinicopathologic variables possibly associated with outcome were compared.

The laparoscopic and open groups had similar demographics. No patient undergoing the laparoscopic procedure experienced conversion to the open technique. No postoperative mortality occurred in either group. The estimated blood loss was significantly lower in the laparoscopic group than in the open group. Although the operating time in the laparoscopic group was significantly longer (358 vs. 278 min; p = 0.004), the patients in this group had bowel function return 1 day sooner on the average than those in the open group. No significant differences in postoperative complications were observed between the groups. The overall survival was 58.7% at 3 years and 49.2% at 5 years. The 3-year overall survival rate in the laparoscopic group was not significantly different from that in the open group (52.8 vs. 61.0%; p = 0.713).

Laparoscopic colorectal resection with simultaneous resection of liver metastases has an outcome similar to that for an open approach but some short-term advantages.