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The impact of synchronous liver resection on the risk of anastomotic leakage following elective colorectal resection. A propensity score match analysis on behalf of the iCral study group

2021; Elsevier BV; Volume: 47; Issue: 11 Linguagem: Inglês

10.1016/j.ejso.2021.05.042

1532-2157

Francesco Guerra, Filippo Petrelli, Paola Antonella Greco, Valerio Sisti, Marco Catarci, Roberto Montalti, Alberto Patriti, Vincenzo Alagna, Pietro Maria Amodio, Gabriele Anania, Riccardo Angeloni, Elisa Arici, Gian Luca Baiocchi, Maddalena Baraghini, Michele Benedetti, Elisa Bertocchi, Felice Borghi, Giuseppe Brisinda, Roberto Campagnacci, Gabriella Teresa Capolupo, Marco Caricato, A. Carrara, Marcello Ceccaroni, Maria Michela Chiarello, D Cianflocca, Paolo Ciano, Simone Cicconi, Marco Clementi, Paolo Delrio, Tatiana Di Cesare, Carlo Di Marco, Alessandro Falsetto, Gianluca Garulli, Simone Guadagni, Gianluca Guercioni, M. Lambertini, Andrea Liverani, Graziano Longo, Andrea Lucchi, Andrea‐Pierre Luzzi, Raffaele Palmieri, Stefano Mancini, Pierluigi Marini, Patrizia Marsanic, Antonio Martino, Giacomo Martorelli, Irene Marziali, Angela Maurizi, M. Migliore, Sarah Molfino, Michele Motter, Andrea Muratore, Ugo Pace, Lorenzo Pandolfini, Maurizio Pavanello, Felice Pirozzi, Giacomo Ruffo, Benedetta Ruggeri, Andrea Sagnotta, Simone Santoni, Stefano Scabini, Marco Scatizzi, Antonio Sciuto, Giuseppe Sica, Giuseppe Tirone, Federico Tomassini, Nereo Vettoretto, Daniele Zigiotto,

Pancreatic and Hepatic Oncology Research

Introduction how best to manage patients with colorectal cancer and synchronous liver metastasis is still controversial, with specific concerns of increased risk of postoperative complications following combined resection. We aimed at analyzing the influence of combined liver resection on the risk of anastomotic leak (AL) following colorectal resection. Methods we reviewed the iCral prospectively maintained database to compare the relative risk of AL of patients undergoing colorectal resection for cancer to that of patients receiving simultaneous liver and colorectal resection for cancer with isolated hepatic metastases. The incidence of AL was the primary outcome of the analysis. Perioperative details and postoperative complications were also appraised. Results out of a total of 996 patients who underwent colorectal resection for cancer, 206 receiving isolated colorectal resection were compared with a matched group of 53 patients undergoing simultaneous liver and colorectal resection. Combined surgery had greater operative time and resulted in longer postoperative hospitalization compared to colorectal resection alone. The proportion of overall morbidity following combined resection was significantly higher than after isolated colorectal resection (56.6% vs. 37.9%, p = 0.021). Overall, the two groups of patients did not differ neither on the rate of major postoperative complications, nor in terms of AL (9.4% vs. 6.3%, p = 0.381). At specific multivariate analysis, the duration of surgery was the only risk factor independently associated with the likelihood of AL. Conclusions combining hepatic with colorectal resection for the treatment of synchronous liver metastasis from colorectal cancer does not increase significantly the incidence of AL.