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Laparoscopic versus open resection of primary colorectal cancers and synchronous liver metastasis: a systematic review and meta-analysis.
Morarasu, Stefan; Clancy, Cillian; Gorgun, Emre; Yilmaz, Sumeyye; Ivanecz, Arpad; Kawakatsu, Shoji; Musina, Ana Maria; Velenciuc, Natalia; Roata, Cristian Ene; Dimofte, Gabriel Mihail; Lunca, Sorinel.
Afiliación
  • Morarasu S; 2nd Department of Surgical Oncology, Regional Institute of Oncology (IRO), Iasi, Romania.
  • Clancy C; Grigore T, Popa University of Medicine and Pharmacy, Iasi, Romania.
  • Gorgun E; Department of Colorectal Surgery, Tallaght University Hospital, Dublin 24, Ireland. clancyci@tcd.ie.
  • Yilmaz S; Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, USA.
  • Ivanecz A; Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic Main Campus, Cleveland, USA.
  • Kawakatsu S; Department of Abdominal and General Surgery, University Medical Center Maribor, Maribor, Slovenia.
  • Musina AM; Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  • Velenciuc N; 2nd Department of Surgical Oncology, Regional Institute of Oncology (IRO), Iasi, Romania.
  • Roata CE; Grigore T, Popa University of Medicine and Pharmacy, Iasi, Romania.
  • Dimofte GM; 2nd Department of Surgical Oncology, Regional Institute of Oncology (IRO), Iasi, Romania.
  • Lunca S; Grigore T, Popa University of Medicine and Pharmacy, Iasi, Romania.
Int J Colorectal Dis ; 38(1): 90, 2023 Apr 05.
Article en En | MEDLINE | ID: mdl-37017766
PURPOSE: Combined resection of primary colorectal cancer and associated liver metastases is increasingly common. This study compares peri-operative and oncological outcomes according to surgical approach. METHODS: The study was registered with PROSPERO. A systematic search was performed for all comparative studies describing outcomes in patients that underwent laparoscopic versus open simultaneous resection of colorectal primary tumours and liver metastases. Data was extracted and analysed using a random effects model via Rev Man 5.3 RESULTS: Twenty studies were included with a total of 2168 patients. A laparoscopic approach was performed in 620 patients and an open approach in 872. There was no difference in the groups for BMI (mean difference: 0.04, 95% CI: 0.63-0.70, p = 0.91), number of difficult liver segments (mean difference: 0.64, 95% CI:0.33-1.23, p = 0.18) or major liver resections (mean difference: 0.96, 95% CI: 0.69-1.35, p = 0.83). There were fewer liver lesions per operation in the laparoscopic group (mean difference 0.46, 95% CI: 0.13-0.79, p = 0.007). Laparoscopic surgery was associated with shorter length of stay (p < 0.00001) and less overall postoperative complications (p = 0.0002). There were similar R0 resection rates (p = 0.15) but less disease recurrence in the laparoscopic group (mean difference: 0.57, 95% CI:0.44-0.75, p < 0.0001). CONCLUSION: Synchronous laparoscopic resection of primary colorectal cancers and liver metastases is a feasible approach in selected patients and does not demonstrate inferior peri-operative or oncological outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía / Neoplasias Hepáticas Tipo de estudio: Etiology_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Int J Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Rumanía Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Laparoscopía / Neoplasias Hepáticas Tipo de estudio: Etiology_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Int J Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Rumanía Pais de publicación: Alemania