ArticleSurgical endoscopy2025
Pushing boundaries: simultaneous minimal-invasive resection of complex colorectal liver metastases and its primary tumor.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSynchronous liver metastases occur in approximately 15-20% of patients with colorectal cancer. Optimal oncological treatment of oligometastatic disease combines surgical resection and systemic therapy. Open simultaneous resection of the primary and liver metastases is well described, but there is not much evidence for the increasing use of the minimally invasive approach. We here report the results of our experience of simultaneous minimally invasive resections.
methodsA prospective database of patients with resection of colorectal liver metastases (CRLM) at the Charité - Universitätsmedizin Berlin was used for retrospective data analysis. We report all patients undergoing simultaneous minimal invasive resection of colorectal cancer and its synchronous liver metastases between May 2015 and December 2021.
resultsOut of 281 patients undergoing resection of CRLM, 33 (11.7%) patients had simultaneous minimal invasive resection of the colorectal primary. The primary tumor was located mostly within the rectum (n = 17; 48.6%), followed by the descending colon (n = 6; 17.1%). CRLM were localized in both liver lobes in 69.7% (n = 23) of cases. Following resection of the colorectal tumor, an anastomosis was performed in 31 of 33 patients (93.9%), with no anastomotic leakage observed in the follow up. Simultaneous liver resections were performed mostly as subsegment (n = 20) or bisegment resections (n = 11). Mean IWATE-Score of all hepatic resections was 5.5 (± 2.4). Complication rates (Clavien-Dindo ≥ 3) were similar compared between low/intermediate and advanced/expert difficulty for liver resection (n = 4, 17.4% vs. n = 2, 20.0%; p = 1.0). In one case conversion to open resection was required.
conclusionOur data indicate that simultaneous minimal invasive resection of CRLM and the primary tumor is a safe and feasible procedure. Complication rates were consistent across different levels of difficulty (low to expert) in liver resections. Therefore, indications for simultaneous resection may be expanded.
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