CRC: synchronous liver resection tied to more complications

  • Jones TJ & al.
  • J Surg Res
  • 5 Feb 2019

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • Synchronous hepatic and colorectal resection in patients with colorectal cancer (CRC) is associated with a higher rate of major complications compared with liver-only resection, but a similar rate of liver complications and mortality.

Why this matters

  • The patient profiles between the 2 groups were similar, suggesting that it may be possible to identify patients at greater risk of complication during synchronous procedures.

Study design

  • Retrospective analysis of 1138 hepatic resections due to CRC metastases from the NSQIP database (98 synchronous liver and colon, 1040 liver resection alone).
  • Funding: None disclosed.

Key results

  • Overall 30-day mortality rate:
    • Overall, 1.1%;
    • Synchronous, 3.1%;
    • Liver-only, 0.9%; P=.077.
  • There was no significant difference between synchronous and liver-only in the frequency of liver failure (3.3% vs 4.1%; P=.722) or biliary leak (5.3% vs 9.6%; P=.084).
  • The synchronous group had higher rates of surgical site infection (14.3% vs 5.6%; P=.001), sepsis (9.2% vs 3.9%; P=.016), length of hospital stay (9.39 vs 6.26 days; P<.001 repeat operation vs p=".017)," and need for postoperative intervention a complication>
  • The synchronous group had a greater probability of experiencing a major complication (OR, 2.5; P<.001>

Limitations

  • Retrospective analysis.