Abstract
Background: While laparoscopic resection of the colorectal carcinoma (CRC) and laparoscopic hepatectomy have rapidly evolved in the past years, there is a lack of reported experiences in totally laparoscopic [TL] simultaneous resection [SR] in CRC with synchronous liver metastasis (LM). Methods: A retrospective analysis of a single-center experience was performed. ASA=4 or ECOG>2 patients, symptomatic primary tumors and low rectal tumors were excluded. 4 points in the Iwate score were not exceeded. Results: A total of 12 TL-SR were carried out from August 2009 to December 2018. 6 patients were female and median age was 61,5±12,04 years. 8 tumors were located in the colon and 4 in the rectum. 14 LM were diagnosed preoperatively (11 unique, 1 triple); however, 4 new LM were found with intraoperative-US. Liver surgery consisted in: 1 case of left lateral sectionectomy and 11 cases of non-anatomical resections. Radiofrequency ablation was associated in 1 case. Mean operative time was 320±25 minutes. Surgery started with the liver resection in 10 cases. 3 cases (25%) presented major complications: one biliary leak with pseudoaneurysm of the liver artery in an hemophiliac patient, one subcapsular liver collection and one anastomotic leak in a rectal tumor that received neoadjuvant chemotherapy. Median hospital stay was 6,5 days (4-34). After a median of follow-up: 19 months (IQR 12-33), tumor progression was observed in 4 cases (33.3%): 3 in the liver, all of which received rescue surgery with curative intention and 1 generalized who received palliative chemotherapy. Median time to recurrence 8,5 months (r1-22). An hemophiliac patient died at 5th month due to a stroke (disease free). Conclusions: Totally laparoscopic simultaneous resection of stage IV CRC with LM is technically feasible in selected patients without a significant increase of morbimortality and no impairment of oncological outcomes although more experience and longer follow-up are needed.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
