Minimally Invasive Simultaneous Colorectal and Liver Resection for Synchronous Colorectal Liver Metastasis-Short-Term Outcomes

Kunal Nandy; Mufaddal Kazi; Shraddha Patkar; Gurudutt Varty; Ashwin De Souza; Avanish Saklani; Mahesh Goel

doi:10.1007/s13193-024-01901-5

Minimally Invasive Simultaneous Colorectal and Liver Resection for Synchronous Colorectal Liver Metastasis-Short-Term Outcomes

Indian J Surg Oncol. 2024 Jun;15(2):268-275. doi: 10.1007/s13193-024-01901-5. Epub 2024 Feb 23.

Authors

Kunal Nandy¹, Mufaddal Kazi², Shraddha Patkar², Gurudutt Varty¹, Ashwin De Souza², Avanish Saklani², Mahesh Goel¹

Affiliations

¹ Division of Hepatobiliary Surgical Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra India.
² Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, Maharashtra India.

PMID: 38741649
PMCID: PMC11088587 (available on 2025-06-01)
DOI: 10.1007/s13193-024-01901-5

Abstract

Surgical management of colorectal disease and liver metastatectomy can be staged or synchronous. A minimally invasive approach in synchronous resection in the selected group of patients may improve postoperative outcomes. The present study aimed to explore the safety and feasibility of simultaneous liver and colorectal resection for synchronous metastasis by a minimally invasive approach in terms of major morbidity and R0 resection rates. The present study is a retrospective review of a prospectively maintained database. All patients who underwent minimally invasive simultaneous resection of colorectal malignancy and liver metastases between January 2020 and April 2023 were included. A total of 39 patients were included in the study. The median age was 54 (23-79) years with 28 male (72%) and 11 female (28%) patients. Rectum (n = 21, 54%) was the most common primary location. The most commonly performed procedures were low anterior resection (n = 12) and parenchymal sparing non-anatomical resection (n = 23, 59%). The median surgery duration was 280 (150-520) min, and the median blood loss was 400 (50-2100) ml. The median hospital stay was 7 (5-18) days. Five (12.6%) patients had major complications. With a median follow-up of 12 months, the 2-year overall survival (OS) and disease-free survival (DFS) were 84.6% and 37%, respectively. Simultaneous liver and colorectal resection by minimal access approach is feasible in selected groups of patients depending on the extent of hepatectomy, the patient's general condition, and surgical team experience. A minimal access approach leads to faster recovery without compromising on the oncological radicality.

Keywords: Colorectum; Hepatectomy; Laparoscopy; Minimal access; Synchronous.

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