To investigate the safety and efficacy of three synchronous surgical methods (traditional open surgery, laparoscopic surgery, and laparoscopy-assisted surgery) in the treatment of patients with colorectal cancer liver metastases (CRLM).

A retrospective analysis was conducted on 146 patients with CRLM who underwent synchronous resection in the First Affiliated Hospital of Anhui Medical University between January 2010 and June 2023. The patients were divided into three groups based on the surgical methods: open surgery group (94 cases, open radical resection of colorectal cancer + open hepatectomy for liver metastases), laparoscopic surgery group (39 cases, laparoscopic radical resection of colorectal cancer + laparoscopic hepatectomy for liver metastases), and laparoscopy-assisted surgery group (13 cases, laparoscopic radical resection of colorectal cancer + open hepatectomy for liver metastases). Baseline characteristics, intraoperative conditions (operation time, blood loss, blood transfusion volume), postoperative recovery (postoperative hospital stay, time to first flatus and defecation, liver function), and complication rates were compared among the three groups. All patients were followed up until January 31, 2024, and disease-free survival (DFS) and overall survival (OS) were compared.

Significant differences were observed among the three groups in body mass index, primary tumor location, and primary tumor T stage (P<0.05). The operation time in the open surgery group was significantly shorter than that in the other two groups (P<0.001). The postoperative stay in the laparoscopic group was significantly shorter than that in the laparoscopy-assisted group and the open surgery group (P<0.05). The overall incidence of postoperative complications in the open surgery group was significantly higher than that in the other two groups (P<0.001). Survival analysis showed no significant difference in DFS among the three surgical methods (P=0.654), while the laparoscopy-assisted surgery group had the longest OS (P=0.03).

Open surgery, laparoscopic surgery, and laparoscopy-assisted synchronous surgery can achieve comparable efficacy in the treatment of CRLM. Laparoscopic surgeries demonstrate significant advantages in early postoperative recovery and the reduction of postoperative complication rates.