EP940 - Combined Hepatic Artery Infusion Pump and Segmental Colectomy

Tuesday, May 13, 2025

8:05 AM – 8:10 AM PT

ePoster Presenter(s)

BM

Brian Monahan, MD

Colorectal Fellow
Medstar Health
Washington, DC, DC, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

ZS

Zhifei (Jeff) Sun, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

BB

Brian Bello, MD

Regional Chief of Colorectal Surgery
MedStar Health

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SB

Sara Berkey, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
PA

Preetha Ali, MD

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
Erin Teeple, MD

Faculty
MedStar Washington Hospital Center
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
PR

Pejman Radkani, MD

Asssociate Profressor of Surgery, Chief Hepatobiliary Surgery
MedStar Health
Washington, District of Columbia, United States

Disclosure information not submitted.
Anne Fabrizio, MD (she/her/hers)

Assistant Professor of Surgery
MedStar Health
Washington, District of Columbia, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
DM

Dimitrios Moris, MD

Fellow Hepatobiliary Surgery
MedStar Health
Washington, District of Columbia, United States

Disclosure information not submitted.
EW

Emily Winslow, MD

HPB Surgeon MedStar Health
MedStar Health
Washington, District of Columbia, United States

Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.

Brian Monahan, MD: This individual has no financial relationships with ineligible companies.

Zhifei (Jeff) Sun, MD: This individual has no financial relationships with ineligible companies.

Brian Bello, MD: This individual has no financial relationships with ineligible companies.

Sara Berkey, MD: This individual has no financial relationships with ineligible companies.

Preetha Ali, MD: This individual has no financial relationships with ineligible companies.

Erin Teeple, MD: This individual has no financial relationships with ineligible companies.

Anne Fabrizio, MD: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Colorectal cancer metastases to the liver are a frequent cause of morbidity and mortality for patients. Historically, metastases were managed with systemic chemotherapy or isolated metastectomy. Recently, placement of hepatic artery infusion pump (HAIP) has been used to provide targeted high dose chemotherapy for liver metastases and has been shown to improve survival. The safety and efficacy of combined HAIP with and without hepatectomy and segmental colectomy, especially in a minimally invasive setting, has not been well-studied.

Methods/Interventions: Retrospective review of patients at a multi-hospital health system who underwent HAIP alone or combined HAIP with colectomy and hepatectomy for metastatic colorectal cancers from 2022-2024 were evaluated for perioperative complications, length of stay, operating times, and 30-day mortality. Analysis was conducted using comparative statistics.

Results/Outcomes: Chart review identified seven patients who underwent HAIP placement. Four patients underwent synchronous colectomy (3-sigmoid colectomy and 1 right colectomy). 3 patients had a synchronous hepatectomy at the same time as their pump and colectomy. Two were performed minimally invasively. Patients who underwent synchronous colectomy had an operative time of 10h 51min (+/- 1h36min) versus metachronous 9h 23min (+/- 4h36min). The average length of stay was 7days (+/-1.8 days) for synchronous cases and 3.5 days (+/-1.2 days) for HAIP alone. There were no 30-day mortality. Only one Clavien-Dindo class III complication was observed requiring return to the operating room for a port site hernia requiring bowel resection. One patient required a post operative blood transfusion. There were no other complications in either group including surgical site infection (SSI), deep venous thrombosis (DVT), or cardiopulmonary complications.
There were no 30 day or 1 year mortality. Of all the patients, only one is deceased at eighteen months post op. Only one Clavien-Dindo class III complication was observed requiring return to OR for an anastomotic leak.

Conclusion/Discussion: Synchronous HAIP and colectomy can be performed minimally invasively and is associated with safe outcomes in well-selected patients. Performing the procedures simultaneously can help minimize multiple admissions, decrease total length of stay and allow patients earlier resumption of chemotherapy for the treatment for metastatic colorectal cancer. Additional studies may be considered to determine optimal patient selection and evaluate long-term oncologic benefits to performing the procedures simultaneously.