One-stage, totally laparoscopic major hepatectomy and colectomy for colorectal neoplasm with synchronous liver metastasis: Safety, feasibility and short-term outcome
Spampinat MG et al. – In highly selected patients, a totally laparoscopic approach is a feasible and safe option to treat primary colorectal neoplasm with synchronous liver metastasis requiring major hepatectomies. These results need to be validated by larger, prospective, randomized studies.Methods
- From January 2009 to July 2011, 5 patients (3 women and 2 men) with primary colorectal neoplasm and synchronous monolobar liver metastasis requiring a major hepatectomy underwent attempt of 1–stage, totally laparoscopic approach after neoadjuvant chemotherapy.
- A retrospective analysis of prospective collected data was performed.
- There were no conversions to open procedures.
- All the patients but 1 underwent a 1–stage laparoscopic resection.
- Among these, liver procedures were 3 right and 1 left hepatectomy; colonic procedures were 3 sigmoidectomies and 1 anterior resection of the rectum.
- Median operative time was 495 minutes, and duration of hospital stay, 6 days.
- Median estimated blood loss was 475 mL (range, 300–630) with no mortality observed.
- An R0 resection was always achieved. Median follow–up was 14 months (range, 7–20) with 1 recurrence observed in the liver.