Simultaneous laparoscopic liver resection or radiofrequency ablation by single-port approach during elective loop-ileostomy closure: A novel strategy in patients with colorectal metastases

Abstract

Abstract Background To report on the feasibility, the morbidity and the mortality of a novel strategy for patients undergoing loop-ileostomy closure for colorectal cancer with synchronous treatment of colorectal cancer liver metastases (CRCLM). Methods The strategy consisted of laparoscopic liver resection (LLR) or radiofrequency ablation (LRFA) of CRCLM by a single-port approach and a simultaneous elective loop-ileostomy closure. All consecutive patients who underwent this strategy were included. Short-term and middle-term results and the patient’s perioperative satisfaction were recorded. Results Between 2017 and 2019, five patients with CRCLM were treated according to this strategy. The feasibility was 100 %. The overall morbidity was 20 % (n\xa0=\xa01, postoperative ileus) and the mortality was 0 %. The CRCLM were treated by wedge resection (n\xa0=\xa03) or LRFA (n\xa0=\xa03). The mean blood loss was 70\xa0±\xa0116.6\xa0mL [300-50]. The mean operating time was 168\xa0±\xa052.3 [100–220] minutes. The mean LOS was 3.5\xa0±\xa01.4 days [2] , [3] , [4] , [5] . The average EVAN G score was 83.3 % [70–95] showing a global satisfaction of the patients on the perioperative course. The rate of R0 resection was 80 % and the rate of local recurrence was 20 %. The 2-years overall survival rate was 84 % (n\xa0=\xa04). At the end of follow-up, the rate of incisional hernia was 0 %. Conclusions This mini-invasive approach appears to be feasible, safe and useful for patients.