Simultaneous versus staged resection of synchronous colorect
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Researchers found that increased morbidity was linked with simultaneous resection for synchronous colorectal liver metastases which reduced with time.

The objective of this study by journal Surgery was to assess trends in the use as well as the outcomes of patients undergoing simultaneous versus staged resection for synchronous colorectal liver metastases.

Patients undergoing resection for colorectal liver metastases were identified using a multi-institutional database. Trends in use and outcomes of simultaneous resection of colorectal liver metastases were examined over time and compared with that of staged resection after propensity score matching.

Among 1116 patients undergoing resection for colorectal liver metastases, 690 patients had a synchronous disease. Among them, 314 patients underwent simultaneous resection, while 376 had staged resection.

--The proportion of patients undergoing simultaneous resection for synchronous colorectal liver metastases increased over time.

--After propensity score matching, patients undergoing simultaneous resection for synchronous colorectal liver metastases had a higher incidence of overall and severe complications yet comparable 90-day mortality compared with patients undergoing staged resection.

--The incidence of severe morbidity decreased over time.

--Survival was comparable among patients undergoing simultaneous versus staged resection of colorectal liver metastases.

--Following simultaneous resection, severe morbidity and mortality increased incrementally based on the extent of liver resection and complexity of colectomy.

Conclusively, while simultaneous resection was associated with increased morbidity, the incidence of severe morbidity decreased over time. Long-term survival was comparable after simultaneous resection versus staged resection of colorectal liver metastases.

Source: https://doi.org/10.1016/j.surg.2021.01.041
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