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International Journal of Colorectal Disease

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01-02-2011 | Original Article

Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis

Authors: Jinggui Chen, Qingguo Li, Changjian Wang, Huiyan Zhu, Yingqiang Shi, Guangfa Zhao

Published in: International Journal of Colorectal Disease | Issue 2/2011

Abstract

Purpose

The optimal timing of surgical resection for synchronous colorectal liver metastases (SCLMs) remains controversial. The aim of this metaanalysis was to compare outcomes between simultaneous resection and staged resection from all published comparative studies in the literature.

Materials and methods

Databases, including PubMed, Embase, Cochrane Library, Ovid, and Web of Science, were searched to identify studies comparing outcomes following simultaneous resection with staged resection for SCLM. The metaanalysis was performed by RevMan 4.2.

Results

Fourteen comparative studies comprising 2,204 patients were identified. Patients undergoing simultaneous resection were found to have similar operative time (weighted mean difference [WMD], −34.19; 95% confidence interval [CI], −81.32–12.95, P = .16) and intraoperative blood loss (WMD, −161.33; 95% CI, −351.45–28.79, P = .10). Shorter hospital stay (WMD, −4.77; 95% CI, −7.26–2.28, P < .01) and lower morbidity rate (odds ratio [OR], 0.71; 95% CI, 0.57–0.88, P = .002) were observed in simultaneous resection group. The survival rate in the simultaneous resection group did not statistically differ with that in the staged resection group at 1 year (OR, 0.77; 95% CI, 0.51–1.16, P = .21), 3 years (OR, 1.12; 95% CI, 0.85–1.47, P = .43), and 5 years (OR, 1.14; 95% CI, 0.86–1.50, P = .37) postresection, respectively.

Conclusions

Simultaneous resection is safe and efficient in the treatment of patients with SCLM while avoiding a second major operation. In appropriately selected patients, simultaneous resection might be considered as the preferred treatment. Since heterogeneity was detected, caution is needed in interpretation of the results. Better designed, adequately powered studies are required for addressing this issue.

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Title: Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis
Authors: Jinggui Chen
Qingguo Li
Changjian Wang
Huiyan Zhu
Yingqiang Shi
Guangfa Zhao
Publication date: 01-02-2011
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 2/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-010-1018-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Simultaneous vs. staged resection for synchronous colorectal liver metastases: a metaanalysis

Abstract

Purpose

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusions

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