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      Short-Term Outcomes after Simultaneous Colorectal and Major Hepatic Resection for Synchronous Colorectal Liver Metastases

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          Abstract

          Background/Aims: Resection of the liver is the standard therapeutic approach for patients with hepatic metastasis and is the only therapy with curative potential. The optimal timing of surgical resection for synchronous metastases has remained controversial. Methods: From January 1993 to December 2008, our strategy has been to use simultaneous resection for resectable synchronous colorectal and liver metastases. During this period, 115 patients underwent simultaneous colorectal and hepatic resection. We evaluated the short-term outcomes of these patients by reviewing operative and perioperative clinical data. Results: In patients with simultaneous resection, there was no evidence of colorectal complications associated with major hepatectomy or no evidence of hepatic complications related to rectal resection. But increased hepatic complications were apparent with major hepatectomy compared with minor hepatectomy (44 vs. 7.2%, p < 0.001) and patients with rectal resection had increased colorectal complications (23% in the rectal resection vs. 5.3% in the colectomy group, p = 0.034). Conclusions: Simultaneous major hepatectomy and rectal resection can increase the hepatic or colorectal morbidity, respectively. These patients may be considered for staged resections.

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          Author and article information

          Journal
          DSU
          Dig Surg
          10.1159/issn.0253-4886
          Digestive Surgery
          S. Karger AG
          0253-4886
          1421-9883
          2017
          October 2017
          21 March 2017
          : 34
          : 6
          : 447-454
          Affiliations
          aDepartment of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, and bHepatobiliary-Pancreatic Surgery Division, Department of Surgery, University of Tokyo, Graduate School of Medicine, Tokyo, Japan
          Author notes
          *Akio Saiura, MD, PhD, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550 (Japan), E-Mail saiura-tky@umin.ac.jp
          Article
          455295 Dig Surg 2017;34:447-454
          10.1159/000455295
          28319941
          © 2017 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 1, Tables: 4, References: 29, Pages: 8
          Categories
          Original Paper

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