Correlation Between Postoperative Complications and Number of Colorectal Liver Metastases Resected

Abstract

Introduction

This study aimed to describe the relationship between the number of colorectal liver metastases (CRLM) resected and the rate of postoperative complications and to determine a threshold level, if any, for which the risk of postoperative complications outweighs the benefit of resection of metastatic disease.

Methods

This is a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database from 2019 to 2021. Patients were divided into three major groups: one to two, three to four, and more than five CRLM.

Results

A total of 5124 patients had CRLM. Compared to patients with one to two and three to four CRLM, patients with 5+ resections were at increased risk of any complication (1655 [50% for one to two CRLM versus 697 [65%] for three to four CRLM versus 437 [76%] for 5+ LM; P = 0.001), surgical complications (1305 [40%] versus 556 [52%] versus 349 [60%]; P = 0.001), and medical complications (350 [10%] versus 141 [13%] versus 88 [16%]; P = 0.001).

Conclusions

Our data demonstrate a significant increase in any surgical complications with three to four tumors resected and a significant increase in any surgical and medical complications and length of stay >5 ds with five or more tumors resected.