Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis
Hadrien Tranchart, Papa Saloum Diop, Panagiotis Lainas, Guillaume Pourcher, Laurence Catherine,
Dominique Franco,
Ibrahim Dagher,
Laurence Catherine
Radiology, Antoine Béclère Hospital, AP-HP, Clamart
Search for more papers by this authorDominique Franco
Departments of General Surgery
University Paris-Sud, Orsay, France
Search for more papers by this authorCorresponding Author
Ibrahim Dagher
Departments of General Surgery
University Paris-Sud, Orsay, France
Ibrahim Dagher, Department of Surgery, Antoine Béclère Hospital, 157 rue de la Porte de Trivaux, 92141 Clamart Cedex, France. Tel.: +33 (0) 1 45 37 45 45; Fax: +33 (0) 1 45 37 49 78; E-mail: [email protected]Search for more papers by this authorHadrien Tranchart, Papa Saloum Diop, Panagiotis Lainas, Guillaume Pourcher, Laurence Catherine,
Dominique Franco,
Ibrahim Dagher,
Laurence Catherine
Radiology, Antoine Béclère Hospital, AP-HP, Clamart
Search for more papers by this authorDominique Franco
Departments of General Surgery
University Paris-Sud, Orsay, France
Search for more papers by this authorCorresponding Author
Ibrahim Dagher
Departments of General Surgery
University Paris-Sud, Orsay, France
Ibrahim Dagher, Department of Surgery, Antoine Béclère Hospital, 157 rue de la Porte de Trivaux, 92141 Clamart Cedex, France. Tel.: +33 (0) 1 45 37 45 45; Fax: +33 (0) 1 45 37 49 78; E-mail: [email protected]Search for more papers by this authorThis was presented at the International Hepato-Pancreato-Biliary Association on 18–22 April 2010, Buenos Aires, Argentina.
Abstract
Background: The optimal strategy for resectable synchronous colorectal liver metastases remains controversial. Although some authors advocate a staged treatment, an increasing number of studies have reported that combined colorectal and liver resection is safe. Laparoscopic combined resection in primary colorectal cancer with synchronous liver metastases has been reported but there are no specific data for major liver resections. In the present study, we evaluated the feasibility of a simultaneous entirely laparoscopic procedure, in the light of the benefits of laparoscopy in both colon and liver surgery, and discussed the benefits of this strategy.
Methods: Two cases are presented of totally laparoscopic major liver resections associated with laparoscopic colorectal resections for synchronous liver metastases with the emphasis on the technical aspects. Duration of surgery, blood loss and post-operative outcome were evaluated.
Results: Laparoscopic right hepatectomy or left hepatectomy with simultaneous colon resection for liver metastasis was feasible and safe with only one suprapubic 5-mm trocar added to the usual trocar sites. The mean duration of surgery was 327 min with a mean estimated blood loss of 200 ml. The post-operative course was uneventful.
Discussion: In selected patients, laparoscopic major hepatectomies for unilobular synchronous metastases can be safely performed simultaneously with colorectal surgery.
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