Abstract
Background/purpose
One-stage resection of primary colon cancer and synchronous liver metastases is considered an effective strategy of cure. A laparoscopic approach may represent a safe and advantageous choice for selected patients with the aim of improving the early outcome.
Methods
Between January 2008 and October 2008, 7 patients underwent one-stage laparoscopic resection for primary colorectal cancer combined with laparoscopic or robot-assisted liver resection.
Results
A total of five laparoscopic left-colon, one right-colon, and one rectal resections were performed. Three patients underwent preoperative left-colon stenting and two received neoadjuvant chemotherapy. The patient with rectal cancer underwent neoadjuvant radiotherapy. Liver procedures included one bisegmentectomy (segments 2, 3), 3 segmentectomies, 6 metastasectomies, and four laparoscopic ultrasound-guided radiofrequency ablations (LUG-RFAs). One patient with multiple liver metastases was managed by a two-stage hepatectomy partially conducted by a totally laparoscopic approach. The overall postoperative morbidity was null. The median hospital stay was 10 days (range 7–10 days).
Conclusions
This pilot study suggests that laparoscopic one-stage colon and liver resection is feasible and safe. Robot assistance may facilitate liver resection, increasing the number of patients who may benefit from a minimally invasive operation.
Similar content being viewed by others
References
Nordlinger B, Guiguet M, Vaillant JC, Balladur P, Boudjema K, Bachellier P, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer. 1996;77:1254–62.
Adam R. Colorectal cancer with synchronous liver metastases. Br J Surg. 2007;94:129–31.
Capussotti L, Ferrero A, Vigano L, Ribero D, Lo Tesoriere R, Polastri R. Major liver resections synchronous with colorectal surgery. Ann Surg Oncol. 2007;14:195–201.
Karoui M, Charachon A, Delbaldo C, Loriau J, Laurent A, Sobhani I, et al. Stents for palliation of obstructive metastatic colon cancer: impact on management and chemotherapy administration. Arch Surg. 2007;142(7):619–23. discussion 623.
Geiger TM, Tebb ZD, Sato E, Miedema BW, Awad ZT. Laparoscopic resection of colon cancer and synchronous liver metastasis. J Laparoendosc Adv Surg Tech A. 2006;16(1):51–3.
Bretagnol F, Hatwell C, Farges O, Alves A, Belghiti J, Panis Y. Benefit of laparoscopy for rectal resection in patients operated simultaneously for synchronous liver metastases: preliminary experience. Surgery. 2008;144(3):436–41.
Simillis C, Constantinides VA, Tekkis PP, Darzi A, Lovegrove R, Jiao L, et al. Laparoscopic versus open hepatic resections for benign and malignant neoplasms—a meta-analysis. Surgery. 2007;141(2):203–11.
Simsek A, Yagci G, Zeybek N, Gorgulu S, Kaymakcioglu N, Kesim E, et al. Effects of portal triad occlusion on left-sided colonic anastomosis. Int Surg. 2002;87(1):25–30.
Casciola L, Ceccarelli G, Di Zitti L, Valeri R, Bellochi R, Bartoli A, et al. Laparoscopic right hemicolectomy with intracorporeal anastomosis. Technical aspects and personal experience. Minerva Chir. 2003;58(4):621–7.
Casciola L, Codacci-Pisanelli M, Ceccarelli G, Bartoli A, Di Zitti L, Patriti A. A modified umbilical incision for specimen extraction after laparoscopic abdominal surgery. Surg Endosc. 2008;22(3):784–6.
Elias D, Detroz B, Lasser P, Plaud B, Jerbi G. Is simultaneous hepatectomy and intestinal anastomosis safe? Am J Surg. 1995;169(2):254–60.
Weese JL, Ottery FD, Emoto SE. Do operations facilitate tumor growth? An experimental model in rats. Surgery. 1986;100(2):273–7.
Kondo E, Koda K, Takiguchi N, Oda K, Seike K, Ishizuka M, et al. Preoperative natural killer cell activity as a prognostic factor for distant metastasis following surgery for colon cancer. Dig Surg. 2003;20(5):445–51.
Leung KL, Lee JF, Yiu RY, Ng SS, Li JC. Simultaneous laparoscopic resection of rectal cancer and liver metastasis. J Laparoendosc Adv Surg Tech A. 2006;16(5):486–8.
Cherqui D, Husson E, Hammoud R, Malassagne B, Stephan F, Bensaid S, et al. Laparoscopic liver resections: a feasibility study in 30 patients. Ann Surg. 2000;232(6):753–62.
Lacy AM, Delgado S, Castells A, Prins HA, Arroyo V, Ibarzabal A, et al. The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg. 2008;248(1):1–7.
Choi SB, Park JS, Kim JK, Hyung WJ, Kim KS, Yoon DS, et al. Early experiences of robotic-assisted laparoscopic liver resection. Yonsei Med J. 2008;49(4):632–8.
Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. Br J Surg. 2006;93(1):67–72.
Leven J, Burschka D, Kumar R, Zhang G, Blumenkranz S, Dai XD, et al. DaVinci canvas: a telerobotic surgical system with integrated, robot-assisted, laparoscopic ultrasound capability. Med Image Comput Comput Assist Interv Int Conf Med Image Comput Comput Assist Interv. 2005;8(Pt 1):811–8.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Patriti, A., Ceccarelli, G., Bartoli, A. et al. Laparoscopic and robot-assisted one-stage resection of colorectal cancer with synchronous liver metastases: a pilot study. J Hepatobiliary Pancreat Surg 16, 450–457 (2009). https://doi.org/10.1007/s00534-009-0073-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00534-009-0073-y