The impact of synchronous liver resection on the risk of anastomotic leakage following elective colorectal resection. A propensity score match analysis on behalf of the iCral study group.
Colorectal cancer
Simultaneous resection
Synchronous colorectal liver metastasis
Journal
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
ISSN: 1532-2157
Titre abrégé: Eur J Surg Oncol
Pays: England
ID NLM: 8504356
Informations de publication
Date de publication:
11 2021
11 2021
Historique:
received:
07
12
2020
revised:
29
03
2021
accepted:
26
05
2021
pubmed:
14
6
2021
medline:
6
1
2022
entrez:
13
6
2021
Statut:
ppublish
Résumé
how best to manage patients with colorectal cancer and synchronous liver metastasis is still controversial, with specific concerns of increased risk of postoperative complications following combined resection. We aimed at analyzing the influence of combined liver resection on the risk of anastomotic leak (AL) following colorectal resection. we reviewed the iCral prospectively maintained database to compare the relative risk of AL of patients undergoing colorectal resection for cancer to that of patients receiving simultaneous liver and colorectal resection for cancer with isolated hepatic metastases. The incidence of AL was the primary outcome of the analysis. Perioperative details and postoperative complications were also appraised. out of a total of 996 patients who underwent colorectal resection for cancer, 206 receiving isolated colorectal resection were compared with a matched group of 53 patients undergoing simultaneous liver and colorectal resection. Combined surgery had greater operative time and resulted in longer postoperative hospitalization compared to colorectal resection alone. The proportion of overall morbidity following combined resection was significantly higher than after isolated colorectal resection (56.6% vs. 37.9%, p = 0.021). Overall, the two groups of patients did not differ neither on the rate of major postoperative complications, nor in terms of AL (9.4% vs. 6.3%, p = 0.381). At specific multivariate analysis, the duration of surgery was the only risk factor independently associated with the likelihood of AL. combining hepatic with colorectal resection for the treatment of synchronous liver metastasis from colorectal cancer does not increase significantly the incidence of AL.
Identifiants
pubmed: 34119377
pii: S0748-7983(21)00537-0
doi: 10.1016/j.ejso.2021.05.042
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2873-2879Investigateurs
V Alagna
(V)
P Amodio
(P)
G Anania
(G)
R Angeloni
(R)
E Arici
(E)
G Baiocchi
(G)
M Baraghini
(M)
M Benedetti
(M)
E Bertocchi
(E)
F Borghi
(F)
G Brisinda
(G)
R Campagnacci
(R)
G T Capolupo
(GT)
M Caricato
(M)
A Carrara
(A)
M Ceccaroni
(M)
M M Chiarello
(MM)
D Cianflocca
(D)
P Ciano
(P)
S Cicconi
(S)
M Clementi
(M)
P Delrio
(P)
T Di Cesare
(T)
C Di Marco
(C)
A Falsetto
(A)
G Garulli
(G)
S Guadagni
(S)
G Guercioni
(G)
M Lambertini
(M)
A Liverani
(A)
G Longo
(G)
A Lucchi
(A)
A P Luzzi
(AP)
R Macarone Palmieri
(R)
S Mancini
(S)
P Marini
(P)
P Marsanic
(P)
A Martino
(A)
G Martorelli
(G)
I Marziali
(I)
A Maurizi
(A)
M Migliore
(M)
S Molfino
(S)
M Motter
(M)
A Muratore
(A)
U Pace
(U)
L Pandolfini
(L)
M Pavanello
(M)
F Pirozzi
(F)
G Ruffo
(G)
B Ruggeri
(B)
A Sagnotta
(A)
S Santoni
(S)
S Scabini
(S)
M Scatizzi
(M)
A Sciuto
(A)
G Sica
(G)
G Tirone
(G)
F Tomassini
(F)
N Vettoretto
(N)
D Zigiotto
(D)
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2021 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest The authors have no conflicts of interest or financial ties to disclose. No grants or other sources of funding have been received for the drawing up of the present manuscript. The manuscript has not been submitted or is under consideration elsewhere.