scholarly journals Perspectives on Hepatic Metastases and the Minimally Invasive Approach to Resection

EMJ Oncology ◽  
2021 ◽  
pp. 53-61
Author(s):  
Elroy Patrick Weledji
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Colorectal Liver Metastases ◽  
Hepatic Metastases ◽  
Stage Iv ◽  
Invasive Approach ◽  
Stage Iv Colorectal Cancer

Surgical resection is the most effective treatment approach in colorectal liver metastases. The improved survival in Stage IV colorectal cancer is associated with a better diagnosis and evaluation, proper decision-making, improved chemotherapy, and the adoption of parenchymal-sparing hepatic resections. Liver surgery was one of the last frontiers reached by minimally invasive surgery. Surgical techniques and specialised equipment evolved to overcome the technical limitations, making laparoscopic liver resections safe and feasible. The aetiology and pathophysiology of hepatic metastases are discussed along with the rationale for and efficacy of minimally invasive surgery for colorectal liver metastases. Improved imaging techniques, identification of genomic markers, advances in chemotherapy, and personalised therapy will further improve the outcome of minimally invasive surgery in the management of Stage IV colorectal cancer.

scholarly journals Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Jie Gong ◽  
Fengwei Gao ◽  
Qingyun Xie ◽  
Xin Zhao ◽  
Zehua Lei
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Open Surgery ◽  
Colorectal Liver Metastases ◽  
Disease Free Survival ◽  
Simultaneous Resection ◽  
Synchronous Colorectal Liver Metastases

Background: We performed a meta-analysis to evaluate the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases.Methods: A systematic literature search up to April 2021 was done and 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery. They were reporting relationships between the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to assess the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases using the dichotomous or continuous method with a random or fixed-effect model.Results: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time (MD, 35.61; 95% CI, 7.36–63.87, p = 0.01), less blood loss (MD, −151.62; 95% CI, −228.84 to −74.40, p < 0.001), less blood transfusion needs (OR, 0.61; 95% CI, 0.42–0.89, p = 0.01), shorter length of hospital stay (MD, −3.26; 95% CI, −3.67 to −2.86, p < 0.001), lower overall complications (OR, 0.59; 95% CI, 0.45–0.79, p < 0.001), higher overall survival (OR, 1.66; 95% CI, 1.21–2.29, p = 0.002), and higher disease-free survival (OR, 1.49; 95% CI, 1.13–1.97, p = 0.005) compared to open surgery.Conclusions: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases may have less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival with longer operation time compared with the open surgery. Furthers studies are required to validate these findings.

scholarly journals Hepatic resection may improve survival in patients with synchronic colorectal liver metastases operated on for obstructed stage iv colorectal cancer

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e183-e184
Author(s):  
C. Quireze Junior ◽  
A. Machado Santana Brasil ◽  
L. Kenny Morais ◽  
M. Castrillon Rassi ◽  
E. Raymond Le Campion ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Resection ◽  
Colorectal Liver Metastases ◽  
Stage Iv ◽  
Stage Iv Colorectal Cancer

scholarly journals Applicability of minimally invasive surgery for clinically T4 colorectal cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Yu-Tso Liao ◽  
Jin-Tung Liang
Keyword(s):  
Colorectal Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Disease Free Survival ◽  
Stage Iv ◽  
University Hospital ◽  
R0 Resection ◽  
Resection Rate ◽  
Oncological Outcomes

AbstractThe role of minimally invasive surgery (MIS) to treat clinically T4 (cT4) colorectal cancer (CRC) remains uncertain and deserves further investigation. A retrospective cohort study was conducted between September 2006 and March 2019 recruiting patients diagnosed as cT4 CRC and undergoing MIS at a university hospital and its branch. Patients’ demography, clinicopathology, surgical and oncological outcomes, and radicality were analyzed. A total of 128 patients were recruited with an average follow-up period of 33.8 months. The median time to soft diet was 6 days, and the median postoperative hospitalization periods was 11 days. The conversion and complication (Clavien–Dindo classification ≥ II) rates were 7.8% and 27.3%, respectively. The 30-day mortality was 0.78%. R0 resection rate was 92.2% for cT4M0 and 88.6% for pT4M0 patients. For cT4 CRC patients, the disease-free survival and 3-year overall survival were 86.1% and 86.8% for stage II, 54.1% and 57.9% for stage III, and 10.8% and 17.8% for stage IV. With acceptable conversion, complication and mortality rate, MIS may achieve satisfactory R0 resection rate and thus lead to good oncological outcomes for selected patients with cT4 CRC.

scholarly journals Fluorescence-guided minimally-invasive surgery for colorectal liver metastases, a systematic review

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Okker D. Bijlstra ◽  
Friso B. Achterberg ◽  
Lodi Grosheide ◽  
Alexander L. Vahrmeijer ◽  
Rutger-Jan Swijnenburg
Keyword(s):  
Systematic Review ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Liver Metastases ◽  
Invasive Surgery ◽  
Colorectal Liver Metastases

scholarly journals Minimally Invasive Surgery in Pediatric Surgical Oncology

Children ◽  
2018 ◽  
Vol 5 (12) ◽  
pp. 158 ◽  
Author(s):  
Hannah Phelps ◽  
Harold Lovvorn, III
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Surgical Site Infections ◽  
Surgical Oncology ◽  
Current Evidence ◽  
Invasive Approach ◽  
Treatment Regimens ◽  
Pediatric Solid Tumors ◽  
Oncologic Resection

The application of minimally invasive surgery (MIS) to resect pediatric solid tumors offers the potential for reduced postoperative morbidity with smaller wounds, less pain, fewer surgical site infections, decreased blood loss, shorter hospital stays, and less disruption to treatment regimens. However, significant controversy surrounds the question of whether a high-fidelity oncologic resection of childhood cancers can be achieved through MIS. This review outlines the diverse applications of MIS to treat pediatric malignancies, up to and including definitive resection. This work further summarizes the current evidence supporting the efficacy of MIS to accomplish a definitive, oncologic resection as well as appropriate patient selection criteria for the minimally invasive approach.

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