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).

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.

Between 2017 and 2019, five patients with CRCLM were treated according to this strategy. The feasibility was 100 %. The overall morbidity was 20 % (n=1, postoperative ileus) and the mortality was 0 %. The CRCLM were treated by wedge resection (n=3) or LRFA (n=3). The mean blood loss was 70±116.6mL [300-50]. The mean operating time was 168±52.3 [100–220] minutes. The mean LOS was 3.5±1.4 days [2Gignoux B., Pasquer A., Vulliez A., et al. Outpatient colectomy within an enhanced recovery program J Visc Surg 2015 ;  152 : 11-15 [cross-ref]

Cliquez ici pour aller à la section Références, 3Allart K., Sabbagh C., Dhahri A., et al. Short-term outcomes of day-case stoma closure: results of a prospective observational study Dis Colon Rectum 2021 ; in press.

Cliquez ici pour aller à la section Références, 4Boudjema K., Locher C., Sabbagh C., et al. Simultaneous versus delayed resection for initially resectable synchronous colorectal cancer liver metastases: a prospective, open-label, randomized, controlled trial Ann Surg. Epub 2020 ; 0003-4932ahead of print March 20.

Cliquez ici pour aller à la section Références, 5Karoui M., Scatton O. The "Short-Cut" laparoscopic reverse approach: a novel strategy for synchronous colorectal cancer and liver metastases requiring major or complex procedures? World J Surg 2019 ;  43 : 2086-2089 [cross-ref]

Cliquez ici pour aller à la section Références]. 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=4). At the end of follow-up, the rate of incisional hernia was 0 %.

This mini-invasive approach appears to be feasible, safe and useful for patients.