The role of liver surgery in simultaneous synchronous colorectal liver metastases and colorectal cancer resections: a literature review of 1730 patients underwent open and minimally invasive surgery.

Introduction: Colorectal cancer (CRC) is the third most common malignant neoplastic disease in the world. Approximately 25-35% of patients affected by CRC will develop liver metastasis, and a percentage of 15-25% occurred in synchronous liver metastases (SCRLM) at the moment of CRC diagnosis or previously. Our aim is to investigate through an extensive literature review the effectiveness and safety of simultaneous SCRLM and CRC in open, laparoscopic and robotic surgery analyzing pre-, intra- and post-operative surgical outcomes and 1-, 3- and 5- years overall survival and disease-free survival.

Evidence Acquisition: A literature review was carried out on PubMed (Medline) and Cochrane libraries until 16 of April 2022.

Evidence Synthesis: Forty-one articles were included and subjected to a qualitative and quantitative analysis. A total of 3038 patients were included; 1730 out of 3038 (56.94%) patients who underwent a simultaneous resection for SCRLM were identified. The mean age was 61.10±9.95 and a 1170 of males and 840 of females emerges. The mean blood loss was 422.23±238.31 mL, the mean operative time was 368.94±88.47 min. The mean Length of Stay was 14.21±6.06 days; 126 (12.79%) patients were Clavien-Dindo grade ≥III complications.

Conclusions: Minimally invasive surgery (MIS) for simultaneous SCRLM and CRC resections shows peri-operative advantages over open surgery. Furthermore, considering postoperative benefits and long-term outcome, MIS could be the choice treatment in these patients.