Laparoscopic Approach for Simultaneous Treatment of Rectal Cancer and Synchronous Liver Metastases: Indications and Initial Experience

Abstract

Laparoscopy approach first for rectal cancer and synchronous liver metastasis is feasible in selected patients, and can provide curative resection or benefit "down-staging" treatment. Colon "pull-through" anastomosis is a potential method to avoid abdominal incision and decrease the risk of anastomotic leakage. It is worth investigating its advantages over traditional approaches with a prospective randomized controlled study.

Laparoscopic Approach for Primary Colorectal Cancer Improves Outcome of Patients Undergoing Combined Open Hepatic Resection for Liver Metastases

“…Nevertheless, the possibility of a totally laparoscopic treatment in the simultaneous resection of SCLM represents a possible future perspective, albeit with indications that remain to be clearly defined [27,28].…”

Impact of totally laparoscopic combined management of colorectal cancer with synchronous hepatic metastases on severity of complications: a propensity-score-based analysis

“…Presently, many descriptive series are available, including a still limited number of cases [24,[34][35][36][37][38], probably because an adequate experience in laparoscopic surgery of both districts is required and this factor limits widespread diffusion of this technique.…”

Laparoscopic-assisted one-stage resection of rectal cancer with synchronous liver metastasis utilizing a pfannenstiel incision

“…In this case, we highlighted the advantages of performing a simultaneous laparoscopic rectal and hepatic resections, which has been advocated due to its benefit in avoiding a second operation, reducing morbidity, providing a shorter treatment time, less operative trauma, and yielding similar cancer outcomes to that of conventional treatment. [ 6 15 ] Despite the favorable short-term results, which are based on a small number of reported cases, more studies should be conducted on a larger scale assessing both short- and long-term outcomes compared with the conventional multioperation approach. In a recent cohort and meta-analysis review of laparoscopic liver resections, the following concerns were mentioned:[ 11 16 ]…”

“…This era has witnessed an overwhelming success of laparoscopic technology due to its advanced technique as an alternative approach in the management of colorectal cancer liver metastasis in selected patients. [ 6 7 ] One-stage laparoscopic resection of both malignancies is considered as an effective curative strategy in certain patients. [ 8 ] Reports suggest that this technique is feasible, safe, and effective.…”