Abstract
Purpose
The purpose of this study was to compare the feasibility and outcomes of two-stage hepatectomy in patients with or without accompanying digestive surgery.
Methods
We analyzed prospectively data from 56 patients with colorectal liver metastases undergoing two-stage hepatectomy between 1995 and 2009. Patients undergoing associated digestive resection (group I, n = 32) were compared with patients without associated digestive surgery (group II, n = 17).
Results
The feasibility rate was 87.5 % (49 patients). Neither the type and extent of hepatectomy nor the type of chemotherapy administered differed between the two groups. The median interval between hepatectomies was 1.79 and 2.07 months for groups I and II, respectively (not significant). One patient (group I) died of liver failure after the second hepatectomy. Postoperative morbidity rates were comparable: 37.5 % (group I) vs. 35.5 % (group II) after the first hepatectomy and 46.9 % (group I) vs. 52.9 % (group II) after the second hepatectomy. The median hospital stay after the first hepatectomy was longer in group I (13.5 days) than in group II (10 days) (P < 0.01). Median follow-up was 54 months. The median overall survival (OS) was 45.8 months, and 3- and 5-year OS were 58 and 31 %, respectively. Median OS was longer for group II (58 months) than for group I (34 months) (P = 0.048).
Conclusions
Digestive tract resection associated with two-stage hepatectomy does not increase postoperative mortality or morbidity nor does it lead to delay in chemotherapy or a reduction in cycles administered. The need for digestive tract surgery should not affect the surgical management of two-stage hepatectomy patients.
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Acknowledgments
We thank Thérèse Gargi for data management and Rob Stepney (medical writer, Charlbury, UK) for editing the manuscript.
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Stella, M., Dupre, A., Chabaud, S. et al. A comparative study of patients with and without associated digestive surgery in a two-stage hepatectomy setting. Langenbecks Arch Surg 397, 1289–1296 (2012). https://doi.org/10.1007/s00423-012-1002-0
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DOI: https://doi.org/10.1007/s00423-012-1002-0