Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastases

Hepatic resection (HR) is the only option offering a potential cure for patients with synchronous colorectal cancer liver metastases (SCRLM). The optimal timing of HR for SCRLM is still controversial. This study aimed to determine whether simultaneous HR is similar to staged resection regarding the morbidity and mortality rates in patients with SCRLM.

Four hundred and five consecutive patients with SCRLM were treated with either simultaneous (n = 129) or staged (n = 276) HR. The postoperative complications were analyzed retrospectively according to the documented records and hepatectomy databases at the Gastrointestinal Institute.

Perioperative morbidity and mortality did not differ between simultaneous resections and staged resections for selected patients with SCRLM (morbidity, 47.3% versus 54.3%; mortality, 1.5% versus 2.0%, respectively; both p > 0.05). Simultaneous liver resections of three or more segments would not increase the rate of complications compared to staged resections (56.8% and 42.4%, respectively; p = 0.119). Meanwhile, patients with simultaneous resections experienced shorter duration of surgery and postoperative hospitalization time as well as less blood loss during surgery (all p < 0.05).

Simultaneous resections of colorectal cancer primary lesions and hepatic metastases were safe and could serve as a primary option for selected SCRLM patients.