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Laparoscopic-assisted combined colon and liver resection for primary colorectal cancer with synchronous liver metastases: initial experience

Cited 38 time in Web of Science Cited 40 time in Scopus
Authors
Kim, Seong Hoon; Lim, Seok-Byung; Ha, Yun Hyung; Han, Sung-Sik; Park, Sang Jae; Choi, Hyo Seong; Jeong, Seung-Yong
Issue Date
2008-10-10
Publisher
Springer Verlag
Citation
World J Surg 32(12):2701-2706
Keywords
Cohort StudiesColectomy/*methodsColorectal Neoplasms/pathology/*surgeryFeasibility StudiesHepatectomy/*methods*LaparoscopyLength of StayLiver Neoplasms/secondary/*surgeryRetrospective StudiesTreatment Outcome
Abstract
BACKGROUND: Laparoscopic approaches have become increasingly used in selected patients with either colorectal or liver cancer. However, the feasibility of laparoscopic-assisted combined colon and liver resection in primary colorectal cancer with synchronous liver metastases remains unknown. The aim of the present study was to determine the feasibility of laparoscopic-assisted combined colon and liver resection for primary colorectal cancer with synchronous liver metastases. METHODS: Laparoscopic surgery involving intestinal anastomosis was performed for primary colorectal cancer. The liver was then mobilized with the assistance of a hand inserted through the upper midline incision. For minor resections, the parenchymal transection was performed laparoscopically. For major resection involving a hilar dissection, transection was performed according to the standard open techniques under direct vision through the incision. Resected specimens were retrieved directly through the midline incision. RESULTS: Ten patients with primary colorectal cancer and synchronous liver metastases underwent the above procedure between September 2006 and April 2007. Surgical procedures for colorectal cancer included 5 low anterior resections, 3 anterior resections, 1 right hemicolectomy, and 1 subtotal colectomy. Combined hepatic surgery included 6 major hepatectomies, 3 segmentectomies, and 1 tumorectomy. All procedures were successful, with no conversions to open surgery required. The median operation time was 439 min (range: 210-690 min), and the median estimated blood loss was 350 ml (range: 300-1,200 ml). There was no surgical mortality or major morbidity, except in one patient in whom postoperative bleeding at the site of para-aortic node dissection was promptly controlled. CONCLUSIONS: Laparoscopic-assisted combined colon and liver resection is a feasible and safe procedure for the treatment of primary colorectal cancer with synchronous liver metastases.
ISSN
0364-2313 (Print)
Language
English
URI
http://hdl.handle.net/10371/62751
DOI
https://doi.org/10.1007/s00268-008-9761-z
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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