YANG Yang 1 , ZHENG Zhaoyang 1 , CHEN Peng 1 , FENG Xi 2,3 , WEI Yonggang 2,3 , YANG Lie 1,3 , ZHOU Zongguang 1,3
  • 1. Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. Division of Hepatic Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 3. Institute of Digestive Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
FENG Xi, Email: fengxi@wchscu.edu.cn; YANG Lie, Email: lie_222@163.com
colorectal cancer; synchronous liver metastasis; laparoscopic surgery; simultaneous resection
10.7507/1007-9424.202402020
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Objective To explore the security and feasibility of simultaneous laparoscopic surgery for synchronous colorectal cancer liver metastasis (SCRLM). Method The data of 36 patients underwent simultaneous surgery for SCRLM in the Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University from March 2015 to December 2021 were retrospectively collected, and the perioperative outcomes, postoperative morbidity and survival were analyzed. Results The surgical procedure of all 36 enrolled patients were accomplished. The operation time was (328.9±85.8) min. The intraoperative blood loss was 100 (50, 150) mL and 4 cases (11.1%) needed intraoperative transfusion. The time to first flatus was (2.9±0.8) d and the time to liquid diet was (3.2±1.0) d. The average postoperative VAS score was 1.9±0.3. The postoperative length of stay was (6.8±4.3) d, 5 (13.9%) cases developed postoperative complications, which were cured by conservative treatment. No severe complications and death occurred within 30 days after surgery. After a median follow-up of 24.7 months, 15 cases (41.7%) experienced recurrence or metastasis and 1 case (2.8%) died. The 1-, 2- and 3-year disease-free survival rates were 89.8%, 55.0%, 29.2%, respectively. The 1-, 2- and 3-year overall survival rates were 100.0%, 100.0%, 87.5%, respectively. There was no significant differences in disease-free survival rates (χ2=1.675, P=0.196) and OS (χ2=0.600,P=0.439) between patients with (n=26) or without (n=10) neoadjuvant. Conclusions Simultaneous laparoscopic surgery seems to be a secure and feasible strategy for patients with SCRLM, with considerable survival benefits and short-term outcomes including small incision, little bleeding, quick recovery and low complication rate. More high-quality clinical studies are desirable in the future to further confirm the efficacy and safety of this operation.