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Purpose <p>To compare the advantages and disadvantages of simultaneous laparoscopic hepatocolorectal resection and staged resection for colorectal cancer with synchronous liver metastasis.</p> Methods <p>Patients with colorectal cancer and synchronous liver metastases who underwent laparoscopic surgery were divided into simultaneous (<i>n</i> = 38) and staged (<i>n</i> = 56) resection groups and their short-term outcomes and medical expenses were then retrospectively compared.</p> Results <p>The postoperative hospital stay was significantly shorter and the total medical costs were lower in the simultaneous group. However, the major complication rate (Clavien–Dindo classification ≥ 3a) was higher in the simultaneous group (28.9% vs. 12.5%, <i>P</i> = 0.047). After performing propensity score–adjusted logistic regression, simultaneous resection remained significantly associated with major complications (odds ratio, 5.11; <i>P</i> = 0.006). In a univariate analysis, the platelet count &lt; 150,000/µL, liver metastasis diameter ≥ 3&#xa0;cm, and difficulty score ≥ 6 were identified as potential risk factors for major complications in the simultaneous group. In a multivariate analysis, a difficulty score ≥ 6 was a significant risk factor (odds ratio, 9.63; <i>P</i> = 0.004).</p> Conclusions <p>Simultaneous laparoscopic resection reduces the surgical burden and medical costs but carries a heightened perioperative risk. Staged resection should therefore be considered for patients with risk factors, particularly for those requiring hepatectomy with a difficulty score of ≥ 6.</p>

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Benefits and risks of simultaneous versus staged laparoscopic resection for colorectal cancer with synchronous liver metastases

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Shigenori Ei,
  • Takashi Kaizu,
  • Yoshiki Fujiyama,
  • Kazuharu Igarashi,
  • Nobuyuki Nishizawa,
  • Hiroshi Tajima,
  • Hiroyuki Furuya,
  • Takeshi Naitoh,
  • Yusuke Kumamoto

摘要

Purpose

To compare the advantages and disadvantages of simultaneous laparoscopic hepatocolorectal resection and staged resection for colorectal cancer with synchronous liver metastasis.

Methods

Patients with colorectal cancer and synchronous liver metastases who underwent laparoscopic surgery were divided into simultaneous (n = 38) and staged (n = 56) resection groups and their short-term outcomes and medical expenses were then retrospectively compared.

Results

The postoperative hospital stay was significantly shorter and the total medical costs were lower in the simultaneous group. However, the major complication rate (Clavien–Dindo classification ≥ 3a) was higher in the simultaneous group (28.9% vs. 12.5%, P = 0.047). After performing propensity score–adjusted logistic regression, simultaneous resection remained significantly associated with major complications (odds ratio, 5.11; P = 0.006). In a univariate analysis, the platelet count < 150,000/µL, liver metastasis diameter ≥ 3 cm, and difficulty score ≥ 6 were identified as potential risk factors for major complications in the simultaneous group. In a multivariate analysis, a difficulty score ≥ 6 was a significant risk factor (odds ratio, 9.63; P = 0.004).

Conclusions

Simultaneous laparoscopic resection reduces the surgical burden and medical costs but carries a heightened perioperative risk. Staged resection should therefore be considered for patients with risk factors, particularly for those requiring hepatectomy with a difficulty score of ≥ 6.