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Laparoscopic and robot‐assisted one‐stage resection of colorectal cancer with synchronous liver metastases: a pilot study
Author(s) -
Patriti Alberto,
Ceccarelli Graziano,
Bartoli Alberto,
Spaziani Alessandro,
Lapalorcia Luigi Maria,
Casciola Luciano
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-009-0073-y
Subject(s) - stage (stratigraphy) , medicine , resection , colorectal cancer , general surgery , cancer , radiology , surgery , geology , paleontology
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.