Clinical efficacy and safety of laparoscopic hybrid surgery for simultaneous resection of colorectal cancer liver metastases

doi:10.3748/wjg.v32.i32.119375

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Aug 28, 2026; 32(32): 119375
Published online Aug 28, 2026. doi: 10.3748/wjg.v32.i32.119375

Clinical efficacy and safety of laparoscopic hybrid surgery for simultaneous resection of colorectal cancer liver metastases

Wei Zhang, Guan-Yu Yu, Li-Qiang Hao, Wei-Ping Zhou, Gang Li, Hao Wang, En-Da Yu, Hai-Feng Gong, Le-Qi Zhou, Rong-Bo Wen, Xiao-Ming Zhu, Tian-Shuai Zhang

Tian-Shuai Zhang, Xiao-Ming Zhu, Rong-Bo Wen, Le-Qi Zhou, Hai-Feng Gong, En-Da Yu, Hao Wang, Li-Qiang Hao, Guan-Yu Yu, Wei Zhang, Department of Colorectal Surgery, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China

Gang Li, Department of the Hepatobiliary and Pancreatic Surgery, Shanghai Changhai Hospital, Naval Medical University, Shanghai 200433, China

Wei-Ping Zhou, Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai 200433, China

Co-first authors: Tian-Shuai Zhang and Xiao-Ming Zhu.

Co-corresponding authors: Guan-Yu Yu and Wei Zhang.

Author contributions: Zhang TS and Zhu XM contributed to formal analysis, visualization, and writing-original draft as co-first authors; Wen RB, Zhou LQ, and Gong HF contributed to the investigation; Yu ED, Wang H, Li G, Zhou WP, and Hao LQ contributed to data curation; Yu GY and Zhang W contributed to conceptualization, funding acquisition, project administration, and writing-review and editing as co-corresponding authors. All authors approved the final version to publish.

Supported by National Natural Science Foundation of China, No. 82473439 and No. 82503486; Shanghai “Rising Stars of Medical Talents” Youth Development Program of the Shanghai Municipal Health Commission, China, No. 2024-70; Naval Medical University “Deep Blue” Project Talent Program; the First Affiliated Hospital of Naval Medical University Special Project for Basic Medical Research, China, No. 2023QD003 and No. 2023PY04; the First Affiliated Hospital of Naval Medical University Special Project for Clinical Research, China, No. 2024 LYA02; and Shanghai Science and Technology Plan Project, No. 25SF1901500.

Institutional review board statement: This study was approved by the Ethic Committee of Changhai Hospital, No. CHEC2017-235.

Informed consent statement: Written informed consent was obtained from all participants. All patient data were anonymized prior to analysis to ensure confidentiality.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: Data are available on reasonable request from the corresponding author.

Corresponding author: Wei Zhang, MD, PhD, Chief, Professor, Department of Colorectal Surgery, Shanghai Changhai Hospital, Naval Medical University, No. 168 Changhai Road, Yangpu District, Shanghai 200433, China. weizhang2000cn@163.com

Received: January 28, 2026
Revised: March 31, 2026
Accepted: May 29, 2026
Published online: August 28, 2026
Processing time: 188 Days and 5.9 Hours

Abstract

BACKGROUND

Simultaneous resection of colorectal cancer liver metastases (CRLM) has been widely adopted; however, clinical efficacy still varies across different surgical approaches, and the best surgical strategy remains controversial.

AIM

To investigate the efficacy and safety of laparoscopic hybrid surgery (LHS) vs total open surgery (TOS) the in simultaneous resection of CRLM.

METHODS

This was an observational study conducted at a tertiary medical center, enrolling 266 patients who undergoing simultaneous resection of CRLM from January 2017 to June 2021. The surgical approach was selected by colorectal surgeons and hepatobiliary surgeons based on their experience with either TOS or LHS. The primary outcomes were the incidence of complications, and postoperative recovery related outcomes. The secondary outcomes were 5-year overall survival and disease-free survival.

RESULTS

This study ultimately enrolled 144 patients in the LHS group and 122 patients in the TOS group. The complication rate was significantly lower in the LHS group than in the TOS group (10.4% vs 20.5%, P = 0.022). Compared with the TOS group, patients in the LHS group had shorter postoperative hospital stay [8.00 (6.00, 10.00) days vs 9.00 (8.00, 12.00) days, P < 0.001], earlier resumption of liquid intake [3.00 (3.00, 3.00) days vs 4.00 (3.00, 4.00) days, P < 0.001], and less intraoperative blood loss [300.00 (200.00, 400.00) mL vs 500.00 (500.00, 700.00) mL, P < 0.001]. However, the LHS group was associated with a longer operative time [260.00 (236.00, 320.00) minutes vs 240.00 (195.00, 269.00) minutes, P < 0.001]. No significant differences were observed in overall survival (P = 0.464) or disease-free survival (P = 0.838).

CONCLUSION

Compared with TOS, LHS for simultaneous resection of CRLM results in faster postoperative recovery, lower complication rates, and similar survival outcomes.

Keywords: Colorectal cancer; Colorectal cancer liver metastasis; Laparoscopic hybrid surgery; Simultaneous resection; Surgical approach

Core Tip: The best simultaneous resection strategy for patients with colorectal cancer liver metastases remains controversial. In this study, we innovatively propose a laparoscopic hybrid surgery (LHS) approach for simultaneous resection of colorectal cancer liver metastases. Compared with totally open surgery, the incidence of complications in the LHS group was significantly lower (10.4% vs 20.5%, P = 0.022). Patients treated with LHS had a shorter postoperative length of stay, earlier postoperative intake of liquids, less blood loss, and similar survival outcomes (overall survival, P = 0.464; disease-free survival, P = 0.838) to those treated with totally open surgery.