Laparoscopic resections for stage IV colorectal cancer - safety and effectiveness of the method as a guarantee for an uncomplicated postoperative period and optimal pharmacotherapeutic results

Introduction : Primary tumor resection can prevent future tumor-related complications in patients with stage IV colorectal cancer. This may influence the quality of life and prevent colostomies associated with the emergency surgery. Laparoscopic approach plays an important role in attempts to reduce perioperative complications in this specific group of patients. Purpose : The aim is to assess early perioperative results in a group of 17 patients with stage IV colorectal cancer—multiple incurable liver metastases and/or pulmonary/peritoneal metastases of the disease. On the other hand, postoperative complications may delay administration of chemotherapy and influence survival. Materials and methods : We analyze retrospectively the perioperative results in a group of 17 patients with laparoscopic palliative colorectal resections for stage IV colorectal cancer. Assessment includes perioperative complications, median hospital stay, perioperative blood loss, need for blood transfusion, operative time, and type of surgical procedure. Results : We performed totally laparoscopic 10 sigmoid resections, five left colectomies, and two right colectomies. Fourteen simultaneous liver biopsies were performed during laparoscopy. No perioperative deaths were registered. Perioperative mortality rate is 0%. Perioperative morbidity rate is 0%. No perioperative complications. The median perioperative stay is 5.3 days. Median blood loss is 47.9 mL. Overall, three units of blood were transfused. The median transfusion rate is 0.17 units per patient. The median operative time is 130.2 minutes. Conclusion : The laparoscopic approach is associated with very good perioperative results in patients with stage IV colorectal cancer and palliative resection of the primary tumor. Early hospital discharge and minimal operative trauma may not influence early administration of chemotherapy.