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14.04.2017 | 2016 SSAT Plenary Presentation | Ausgabe 6/2017

Journal of Gastrointestinal Surgery 6/2017

Simultaneous Resection for Synchronous Colorectal Liver Metastasis: the New Standard of Care?

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 6/2017
Autoren:
Jonathan S. Abelson, Fabrizio Michelassi, Tianyi Sun, Jialin Mao, Jeffrey Milsom, Benjamin Samstein, Art Sedrakyan, Heather L. Yeo
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-017-3422-1) contains supplementary material, which is available to authorized users.
This work was presented as an oral presentation at Digestive Diseases Week/Society for Surgery of the Alimentary Tract, May 2016 in San Diego, CA.

Abstract

Background

Optimal surgical management for patients with synchronous colorectal cancer liver metastasis is controversial. We provide an analysis of surgical utilization and outcomes for patients presenting with synchronous colon and rectal cancer liver metastasis between simultaneous and staged approaches.

Methods

SPARCS database was used to follow patients undergoing surgery for colorectal cancer with liver metastases from 2005 to 2014. Using International Classification of Diseases, Ninth Revision codes, we identified patients undergoing staged and simultaneous resection. Our primary endpoint was major events at 30-day follow-up.

Results

Of the patients, 1430 underwent surgery for synchronous colorectal primary and liver metastases between 2005 and 2014. There was no difference in adjusted rates of major events or anastomotic leak. Patients undergoing simultaneous resection were significantly less likely to experience prolonged length of stay (OR = 0.28; 95% CI = 0.21–0.37) or high hospital charges (OR = 0.24; 95% CI = 0.17–0.32) compared to staged resection even among patients undergoing total hepatic lobectomy and complex colorectal resection.

Conclusions

Simultaneous resection was found to be equally as safe as staged resection even when evaluating patients undergoing more complex operations, and led to lower health care utilization. Under appropriate clinical circumstances, simultaneous resection offers benefits to patients and the health care system and should be the recommended surgical approach.

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Zusatzmaterial
Table S1 (DOCX 12 kb)
11605_2017_3422_MOESM1_ESM.docx
Table S2 (DOCX 14 kb)
11605_2017_3422_MOESM2_ESM.docx
Literatur
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