Conversion following minimally invasive attempt at simultaneous colorectal and liver resection does not affect 30-day postoperative overall morbidity

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2025-05-30 DOI:10.1111/codi.70128

Lawrence B. Brown, Shannon N. Radomski, Miloslawa Stem, Susan L. Gearhart, Haniee Chung, Vincent J. Obias, Alodia Gabre-Kidan

{"title":"Conversion following minimally invasive attempt at simultaneous colorectal and liver resection does not affect 30-day postoperative overall morbidity","authors":"Lawrence B. Brown, Shannon N. Radomski, Miloslawa Stem, Susan L. Gearhart, Haniee Chung, Vincent J. Obias, Alodia Gabre-Kidan","doi":"10.1111/codi.70128","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aim</h3>\n \n <p>Over the past decade, minimally invasive surgery (MIS) approaches have been increasingly utilized for simultaneous colorectal cancer (CRC) and colorectal liver metastasis (CRLM). However, the impact of conversion to open surgery during MIS remains unclear. This study evaluates 30-day postoperative overall morbidity in patients undergoing simultaneous resection for CRC and CRLM tumours.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>We utilized the American College of Surgeons National Surgical Quality Improvement Program database from 2013 to 2022. Adults ≥18 years who underwent surgery for a simultaneous resection of CRC and CRLM were included. Propensity score matching was used to ascertain differences in surgical outcomes between those who underwent a planned open procedure and those who had an MIS that was converted to open.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 2306 patients were included in our study. Of these, the majority underwent a planned open procedure (<i>n</i> = 1831, 79.4%). Of the patients who underwent an MIS approach (<i>n</i> = 381, 20.6%), the majority had a laparoscopic procedure (<i>n</i> = 272, 71.4%) compared to a robotic approach (<i>n</i> = 109, 28.6%). There were significant differences between the three surgical groups by age group (<i>P</i> = 0.012), race (<i>P</i> < 0.001) and risk of procedure (<i>P</i> < 0.001). After propensity score matching, 94 patients remained in the planned open and MIS with conversion groups. There were no significant differences in 30-day postoperative outcomes between these two surgical groups.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Postoperative surgical outcomes between planned open and MIS converted to open procedures were similar. These findings imply that an MIS approach can be attempted for simultaneous resection of CRC and CRLM without adverse outcomes.</p>\n </section>\n </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 6","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Colorectal Disease","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/codi.70128","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

Over the past decade, minimally invasive surgery (MIS) approaches have been increasingly utilized for simultaneous colorectal cancer (CRC) and colorectal liver metastasis (CRLM). However, the impact of conversion to open surgery during MIS remains unclear. This study evaluates 30-day postoperative overall morbidity in patients undergoing simultaneous resection for CRC and CRLM tumours.

Method

We utilized the American College of Surgeons National Surgical Quality Improvement Program database from 2013 to 2022. Adults ≥18 years who underwent surgery for a simultaneous resection of CRC and CRLM were included. Propensity score matching was used to ascertain differences in surgical outcomes between those who underwent a planned open procedure and those who had an MIS that was converted to open.

Results

A total of 2306 patients were included in our study. Of these, the majority underwent a planned open procedure (n = 1831, 79.4%). Of the patients who underwent an MIS approach (n = 381, 20.6%), the majority had a laparoscopic procedure (n = 272, 71.4%) compared to a robotic approach (n = 109, 28.6%). There were significant differences between the three surgical groups by age group (P = 0.012), race (P < 0.001) and risk of procedure (P < 0.001). After propensity score matching, 94 patients remained in the planned open and MIS with conversion groups. There were no significant differences in 30-day postoperative outcomes between these two surgical groups.

Conclusion

Postoperative surgical outcomes between planned open and MIS converted to open procedures were similar. These findings imply that an MIS approach can be attempted for simultaneous resection of CRC and CRLM without adverse outcomes.

查看原文本刊更多论文

微创尝试同时行结肠和肝脏切除术后的转换不影响术后30天的总发病率

在过去的十年中，微创手术（MIS）方法越来越多地用于同时发生的结直肠癌（CRC）和结直肠癌肝转移（CRLM）。然而，MIS期间转换为开放手术的影响尚不清楚。这项研究评估了同时切除CRC和CRLM肿瘤的患者术后30天的总体发病率。方法利用2013 - 2022年美国外科医师学会国家手术质量改进计划数据库。年龄≥18岁的成年人同时接受了CRC和CRLM的手术切除。倾向评分匹配用于确定接受计划开放手术的患者与MIS转换为开放手术的患者之间手术结果的差异。结果共纳入2306例患者。其中，大多数患者接受了计划好的开放式手术（n = 1831, 79.4%）。在接受MIS入路的患者中（n = 381, 20.6%），与机器人入路（n = 109, 28.6%）相比，大多数患者采用腹腔镜手术（n = 272, 71.4%）。三个手术组在年龄（P = 0.012）、种族（P < 0.001）和手术风险（P < 0.001）方面存在显著差异。倾向评分匹配后，94例患者保留在计划开放和MIS转换组。两组患者术后30天的预后无显著差异。结论计划开腹与MIS转开腹的手术效果相似。这些发现表明，MIS方法可以尝试同时切除CRC和CRLM，而不会产生不良后果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.